Pseudogastroparesis as a presentation of adenocarcinoma of the proximal jejunum

Establishing the presence of adenocarcinoma of the small bowel is exceedingly difficult. Survival is contingent on prompt diagnosis. We describe a patient with an atypical presentation of jejunal adenocarcinoma visualized via small bowel enteroclysis. She was referred with "gastroparesis," based on both a radionucleotide scan that revealed markedly delayed gastric emptying and a "normal" small bowel series. A markedly abnormal scintigraphic study and a negative small bowel series does not exclude disease of the small intestine and should provide the impetus to further pursue the possibility of an obstructing lesion. The enteroclysis is a relatively safe and effective study in the preoperative diagnosis of small bowel tumors.