Radiological and endoscopic diagnosis of infrapapillary carcinoma of the duodenum

Primary carcinoma of the duodenum is an uncommon cause of epigastric pain, weight loss, and vomiting. The diagnosis is frequently made at a late stage and the prognosis is poor. These tumours may easily be overlooked if the whole of the duodenum is not examined at barium meal or endoscopy. The clinical, radiological and endoscopic findings in three cases are described and the differential diagnosis is discussed. The possibility of an infrapapillary carcinoma of the duodenum should be considered in all patients with unexplained upper gastrointestinal symptoms or blood loss.