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首页> 外文期刊>Cureus. >Primary Small Bowel Adenocarcinoma Presenting with Duodenal Stricture and Hepatic and Gastroduodenal Artery Encasement: A Case Report
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Primary Small Bowel Adenocarcinoma Presenting with Duodenal Stricture and Hepatic and Gastroduodenal Artery Encasement: A Case Report

机译：原发性小肠腺癌伴十二指肠狭窄和肝胃十二指肠动脉包裹：一例报告

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摘要

Primary small bowel adenocarcinoma is rare, with an estimated U.S. annual incidence of 3.9 cases per million persons, and is often associated with a poor prognosis.?We report a case of a 68-year-old male diagnosed with primary duodenal adenocarcinoma with hepatic artery and gastroduodenal artery encasement.?The patient initially presented with persistent nausea and vomiting unresponsive to ondansetron and metoclopramide, and initial computed tomography (CT) of abdomen and pelvis revealed significant stomach distension concerning for gastric outlet obstruction.?Esophagogastroduodenoscopy (EGD) revealed significant duodenal stricture, with results of triple phase CT of pancreas significant for tissue encasing the common hepatic artery and the origin of the gastroduodenal artery.?Pathology results verified the presence of a moderately differentiated adenocarcinoma involving the small bowel.?Due to artery encasement by the tumor, the patient was deemed to be a poor surgical candidate, and instead received a duodenal stent for symptomatic relief with initiation of a chemotherapy regimen consisting of folinic acid, oxaliplatin, and fluorouracil (FOLFOX) as an outpatient.?This case highlights the presentation and diagnostic workup of a rare cancer.
机译：原发性小肠腺癌罕见，在美国估计每百万人每年发生3.9例，并且通常与预后不良有关。我们报告了一例68岁的男性，被诊断为原发性十二指肠腺癌并伴有肝动脉。病人最初表现为持续的恶心和呕吐，对恩丹西酮和胃复安无反应，最初的腹部和骨盆CT（CT）检查显示胃扩张严重，与胃出口梗阻有关。狭窄，胰腺的三相CT检查结果对于包裹肝总动脉和胃十二指肠动脉起源的组织具有重要意义。病理结果证实存在中度分化的腺癌，涉及小肠。由于肿瘤包裹了动脉，该患者被认为是手术不佳的候选人，并且取而代之的是，在门诊患者开始采用由亚叶酸，奥沙利铂和氟尿嘧啶（FOLFOX）组成的化疗方案后，通过十二指肠支架缓解症状，以突出这种罕见癌症的表现和诊断方法。

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