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Intraluminal Duodenal Diverticulum Combined with Early Duodenal Cancer and Gastric Carcinoid, Report of a Case Michio Kobori 1 , Sanae Nakamura 1 , Sinsuke Watanabe 1 , Tatsuo Kurokawa 2 , Reiji Haba 3 1Department of Internal Medicine, Setonaikai Hospital 2Department of Surgery, Imabari Saiseikai Hospital 3Department of Pathology, lmabari Saiseikai Hospital Keyword: 十二指腸管腔内憩室 , 早期十二指腸癌 , 胃カルチノイド , 胃迷入膵組織 , 十二指腸先天性膜様閉鎖症 pp.1035-1041
Published Date 1996/7/25
DOI https://doi.org/10.11477/mf.1403104202
  • Abstract
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 A 76-year-old woman was referred and admitted to our hospital because routine x-ray films in a private clinic had disclosed duodenal dilatation and gastric protruded lesions. She had been. complaining of occasional vomiting since her youth.

 Five days prior to admission, she complained of anorexia and epigastric discomfort. An upper gastrointestinal series first demonstrated a large smooth hemispheric protrusion extending toward the oral direction in the dilated duodenal bulb. Next time, this protrusion had reversed in the direction of the anus and had the appearance of a sack-like structure surrounded by a thin radiolucent line in the second portion of the duodenum. A flat elevated lesion with irregular surface was detected in the greater curvature of the dilated duodenal bulb. A small submucosal tumor in the gastric antrum and a small polypoid lesion in the lower gastric body were detected. Endoscopic examination showed an IDD which was found to be attached to the whole circumference of the duodenal lumen. A small aperture was found in the center of the IDD and permitted narrow passage for a videoendoscope, from time to time by peristalsis, a hemispherical protrusion in the dilated duodenal bulb was found to have transformed into a deep sack, just like the sail of a yacht. A flat elevated lesion in the duodenal bulb, a submucosal tumor in the antrum and a polypoid lesion with irregularred surface in the lower gastric body were noted. Preoperative diagnosis was an IDD, early duodenal cancer of type IIa, aberrant pancreas of the gastric antrum and polyp of the lower gastric body. Postoperative and pathological diagnosis revealed IDD, early duodenal cancer of type Ⅱa, m, a carcinoid and aberrant pancreas of the stomach. Tbis case of IDD associated with early duodenal cancer and with gastric carcinoid is extremely rare and has never been reported. I suggested the posibility that IDD is related to the derivation of duodenal cancer and gastric carcinoid.


Copyright © 1996, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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