Duodenal adenocarcinoma -a) Most common small bowel carcinomab) Periampullary carcinomac) Jaundice & anemia - most common symptomd) Local resection - curative
• Duodenum is MC site of small intestinal adenocarcinoma
• 15% in the proximal; 40% in the middle and 45% in the distal duodenum (MC)
• Resectability and prognosis are better than other upper GI cancers.
Clinical Features
• Most often presents as obstruction, with nausea, vomiting, and abdominal pain as the most frequent symptoms.
• Anemia from bleeding and biliary or pancreatic obstructive symptoms can also be seen on initial presentation if the tumor is located within the periampullary region.
Diagnosis
• Endoscopy is the diagnostic test of choice for duodenal tumors, which allows for direct visualization and biopsy as needed.
Treatment
• For 1st or 2nd portion: Whipple procedure
• For 3rd or 4th portion: Segmental duodenal resection
ac
bc
ad
b