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Case Report
Primary adenocarcinoma of the angle of Treitz: A case report
1 General Surgery Department, West Hertfordshire Hospitals NHS Trust, UK
2 General Surgery Department, Fayoum University Hospital, Cairo, Egypt
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Sherif Monib
West Hertfordshire Hospitals NHS Trust, St Albans City Hospital, 56 Waverly Road, St Albans, AL3 5PN,
UK
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Article ID: 101173Z01SM2020
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Monib S, Elkorety M, Renaudon-Smith E, Habashy H. Primary adenocarcinoma of the angle of Treitz: A case report. Int J Case Rep Images 2020;11:101173Z01SM2020.ABSTRACT
Introduction: Adenocarcinoma of the fourth part of the duodenum is rare, and patients often present with a long history of non-specific symptoms, sometimes with advanced disease.
Case Report: We report the case of a 41-year-old male patient presenting with symptoms of upper gastrointestinal obstruction. Investigations included upper gastrointestinal (GI) endoscopy, barium follow-through, ultrasound, and computed tomography, which indicated gastric outlet obstruction. The precise nature of the lesion was subsequently revealed following diagnostic laparoscopy and laparotomy where an obstructing mass involving the duodenojejunal junction was identified. Segmental resection with a 2 cm safety margin, end to side anastomosis, and feeding jejunostomy was performed, and the lesion was confirmed as adenocarcinoma with free surgical margins. The patient made a good postoperative recovery with one year follow-up oesophagogastroduodenoscopy (OGD) and computed tomography (CT) scan, excluding local or nodal recurrence.
Conclusion: A high index of suspicion coupled with appropriate investigation and early surgical resection is necessary to manage the disease and improve prognosis.
Keywords: Adenocarcinoma, Angle of Treitz, Gastric outlet obstruction
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Author Contributions
Sherif Monib - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Mohamed Elkorety - Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Edward Renaudon-Smith - Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Hany Habashy - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Sherif Monib et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
