Adenocarcinoma of the duodenojejunal flexure: our recent experience

Duodenal adenocarcinomas account for 0.3% of all gastrointestinal malignancies. Most of them are found in the second portion of the duodenum, while those in the third and/or fourth portions, particularly at the duodenojejunal flexure, are very rare, representing a separate entity.

We had two male patients who presented with non-specific symptoms in the form of pain in the upper abdomen accompanied by nausea and vomiting. After CT diagnostics had revealed duodenal lesions in the region of the Treitz ligament, patients were subjected to operative treatment, with curative intent in the first case and palliative intent in the second case due to peritoneal carcinomatosis.

The insidious onset and vague abdominal symptoms, even when the disease has progressed, coupled with the difficulty of viewing this location and performing a biopsy, make diagnosing these neoplasms particularly difficult. The only possible curative option is surgical resection. A higher degree of suspicion and a more aggressive and persistent investigation should lead to earlier treatment, a higher curative resectability rate, and therefore better long-term results.