[Difficulty in Preoperative Diagnosis of Residual Gastric Cancer after Distal Gastrectomy for Duodenal Ulcer].
A 67-year-old man underwent distal gastrectomy via the Billroth Ⅱ method (B-Ⅱ) for a duodenal ulcer. He presented with appetite loss and nausea in May 2014. Gastrointestinal endoscopy revealed wall thickness around gastrojejunostomy and the gastric mucosal fold. Biopsy and re-biopsy revealed a group 2 tumor. Laparotomy for diagnosis was performed because of stenosis and tumor progression. Intraoperative frozen section examination revealed adenocarcinoma in the lymph nodes of the jejunum. Residual gastrectomy with reconstruction using the Roux-en-Y method was performed for residual gastric cancer. Histopathological findings revealed pT4a, pN0, pM1 for the tumor in the lymph nodes of the jejunum, pStage Ⅳ. A distorted gastrojejunostomy site and the presence of anastomotic strictures are important for the rapid diagnosis of residual gastric cancer.
Dept. of Surgery, Kansai Medical University.
Masanori
M
Yamada
Koji
K
Nakai
Kentaro
K
Inoue
Takeshi
T
Hijikawa
Hiroaki
H
Kitade
Kazuhiko
K
Yoshioka
Masanori
M
Kon
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D004338:Drug Combinations; D004381:Duodenal Ulcer / Q000601:surgery*; D017809:Fatal Outcome; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D008297:Male; D010094:Oxonic Acid / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D005641:Tegafur / Q000627:therapeutic use; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid