Nine patients with
tumors of the duodenum and the jejunum are described herein and the Literature is reviewed. Of the six patients with a duodenal
tumor, five had an
adenocarcinoma and one a Brunner's gland
adenoma. A predominance of inframpullary
tumors was observed within the duodenum.
Jaundice and
abdominal pain were, respectively, the most common presenting symptoms of the
tumors localized in the periampullary and inframpullary region. Treatment was curative in four and palliative in two cases.
Duodenopancreatectomy was the treatment of choice for periampullary
tumors whereas segmental resection was performed in the only resectable distal duodenal
tumor. Of the three patients with
jejunal neoplasms, one had an
adenocarcinoma arising in the efferent loop of a
Billroth II gastrojejunostomy performed 40 years before and two had an high
malignant lymphoma. All three the
tumors could be resected. According to the Literature, our results show that: 1. The diagnosis of duodeno-jejunal
tumors is usually late: 2. Although of critical importance in the improvement of the overall diagnostic accuracy, endoscopy may be inconclusive or even misleading if the entire duodenum is not explored; 3. If
duodenopancreatectomy is mandatory for periampullary
tumors, segmental resection seems to be an adequate procedure for
tumors of the distal duodenum since it does not ignore lymphatic nodes, can be easily performed and has a low postoperative complication rate.