Presentation
Upper abdominal pain, bloating and vomiting.
Patient Data
Age: 60 years
Gender: Female
From the case:
Duodenal adenocarcinoma
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Circumferential wall thickening of D3/D4, just proximal / involving the duodenojejunal junction with upstream duodenal and gastric dilatation. Enlarged mesenteric lymph node sits just anterior to the thickened bowel. No evidence of hematogenous metastases.
Case Discussion
The patient underwent endoscopy confirming D3/D4 adenocarcinoma on biopsy. She underwent a duodenotomy and anastomosis and went on to receive adjuvant chemotherapy with a good response to treatment at one year. The patient had a history of celiac disease, which is a risk factor for small bowel adenocarcinoma, with the risk as high as 60-80x if a late diagnosis and poor adherence to a gluten-free diet.
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