Primary small intestinal adenocarcinoma diagnosed by endoscopic examination prior to operation

Progress in diagnostic procedures has made it possible to diagnose neoplasms of the gastrointestinal tract preoperatively. However, preoperative diagnosis of tumors of the small intestine remains difficult. We report here detection of an adenocarcinoma of the jejunum by endoscopic examination prior to operation. A 73-year-old woman was admitted with complaints of intermittent periumbilical pain, nausea, and vomiting. An upper gastrointestinal series showed an abnormal segmet 10 cm distal to the duodenojejunal flexure. Small intestinal endoscopic examination revealed a tumor with a crater and an irregular surface of mucosa near the duodenojejunal flexure, and annular constriction due to tumor extension, and endoscopic biopsy specimens contained tissue from a poorly differentiated adenocarcinoma. Wide resection, including the duodenum, proximal jejunum, and adjacent mesentery was performed. The resected tumor was confirmed histologically to be a poorly differentiated adenocarcinoma of the jejunum.