[A Case of Primary Small Intestinal Cancer Diagnosed by Double-Balloon Endoscopy and Treated with Single-Incision...

A 73-year-old woman was admitted to our hospital with a 5 months history of epigastric discomfort. Abdominal CT performed on admission revealed localized dilation of the small intestine. The patient was diagnosed with subileus and treatment was initiated with fasting and intravenous fluids. An upper gastrointestinal series revealed an apple core sign in the upper jejunum. Double-balloon enteroscopy identified a type 2 tumor in the upper jejunum, which was marked with ink. A biopsy of the tumor revealed a Group 5 tumor, with no distant metastasis. The patient was diagnosed with primary small intestinal cancer. A single-incision laparoscopic surgery was performed. A circumferential tumor was found in the jejunum, 25 cm from the ligament of Treitz, and a partial small intestinal resection was performed. The postoperative pathological results were tub1>tub2, pT3(SS), int, INF β, Ly0, V1a, PN0, pPM0, pDM0, pN0(0/5), with a final diagnosis of pStage Ⅱ. The postoperative course was uneventful, and the patient was discharged on the 15th postoperative day. The patient has been under observation for 1 year and 5 months after surgery without recurrence or the need for postoperative adjuvant chemotherapy.