CLINICAL STUDY ON THE DIAGNOSIS OF DUODENAL CANCER

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Clinical studies of the diagnosis of duodenal cancer are not reported so much although of course we know, its frequency aeems to be lower than gastric cancer or other gastric diseases.However progress of digestive endoscopy has made acurate diagnosis of this disease.21 cases of cancer of papilla vateri, 6 cases of primary duodenal cancer, and 13 cases of metastatic duodenal cancer have been investigated clinically.Though 80% of cases of cancer of papilla vateri were able to be diagnosed from the characteristic findings of cholangiography by PTC or ERCP that the end of common bile duct showed U shaped obstruction with round filling defect, the other cases were unable to be diagnosed correctly only by X-ray findings.On the other hand, all cases of cancer of papilla vateri were shown endoscopically some diagnostic features consisting of polypoid lesion, ulceration, or erosion at the papilla vateri.Thus, it may be concluded that degree of invasion of cancer of papilla vateri was presumed by endoscopic findings of papilla vateri.On primary duodenal cancer, polypoid lesion (such as IIa) was shown chiefly at the supra-papillary region, while ulcerative lesions (such as Borrman II or III type) were shown at the infra-papillary region. The former was found mostly in the earlier stage than the latter. It may be speculated that the polypoid lesion of primary duodenal cancer had developed to ulcerative lesions according to the growth of cancer.Metastatic duodenal cancer showed endoscopic findings of erosion (IIc like), polypoid lesion (ha like) or small ulcer. In addition, one case of cancer of papilla vateri and one very rare case of primary duodenal cancer in the early stage were reported in detail.
財団法人日本消化器病学会の論文

CLINICAL STUDY ON THE DIAGNOSIS OF DUODENAL CANCER

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