Korean J Helicobacter Up Gastrointest Res.  2019 Sep;19(3):202-206. 10.7704/kjhugr.2019.19.3.202.

Adenocarcinoma of the Proximal Jejunum Misdiagnosed as Gastroparesis

Affiliations
  • 1Department of Internal Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. heehee2210@hanmail.net

Abstract

The prevalence of small bowel cancer is relatively low. The abdominal pain that patients with small bowel cancer present as a symptom is non-specific and often interpreted as a normal finding on radiographic studies. To prevent delayed diagnosis of small bowel cancer, practitioners must maintain a certain level of suspicion. We report a case of delayed diagnosis of jejunal cancer as it was misdiagnosed as gastroparesis. A 69-year-old woman complained of recurrent nausea and vomiting. At the beginning of her hospitalization, we could not diagnose mechanical obstruction through esophagogastroduodenoscopy and abdominal computed tomography. A gastric emptying study revealed delayed gastric emptying. Although the patients received treatments, including administration of prokinetics and botulinum toxin injection, for gastroparesis, her symptoms aggravated. Subsequently, plain radiography of the abdomen revealed a double-bubble sign. Abdominal computed tomography was performed under the suspicion of small bowel obstruction; however, the diagnosis was not clear. Consequently, exploratory laparoscopy was performed. She underwent surgical management, including small bowel segmental resection and duodenojejunostomy, due to the jejunal mass with involvement of the stomach, pancreatic head, and mesentery of the transverse colon. The postoperative pathological results revealed a moderately differentiated adenocarcinoma of the jejunum.

Keyword

Gastric emptying; Gastroparesis; Jejunal neoplasms; Nausea

MeSH Terms

Abdomen
Abdominal Pain
Adenocarcinoma*
Aged
Botulinum Toxins
Colon, Transverse
Delayed Diagnosis
Diagnosis
Endoscopy, Digestive System
Female
Gastric Emptying
Gastroparesis*
Head
Hospitalization
Humans
Jejunal Neoplasms
Jejunum*
Laparoscopy
Mesentery
Nausea
Prevalence
Radiography
Stomach
Vomiting
Botulinum Toxins
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