September 9, 1974

Radiologic Features of Diagnostic Importance

Author Affiliations

From the Department of Radiology, Mt Sinai School of Medicine, City University of New York (Dr. Marshak) and the Department of Medicine, New York University School of Medicine, New York (Dr. Lindner).

JAMA. 1974;229(11):1498-1499. doi:10.1001/jama.1974.03230490078039

ADENOCARCINOMA of the duodenum or small bowel is a rare lesion. Peripapillary carcinomas are usually polypoid, ulcerated, nonobstructive, and immediately adjacent to the papilla of Vater. In the remainder of the duodenum, primary carcinoma is difficult to distinguish from metastatic disease or extension of tumor from the pancreas. In the mesenteric small bowel, primary carcinoma occurs more frequently in the jejunum than in the ileum. The roentgenographic findings are usually a short, fairly sharply demarcated filling defect associated with an eccentric and irregular channel and with overhanging edges. The mucosa is ulcerated and partial obstruction is common.1

In recent years, a number of cases of adenocarcinoma of the small bowel have been reported in association with long-standing regional enteritis or in surgically excluded loops.2 The diagnosis is very difficult to establish preoperatively because the presence of multiple strictures with intervening segments of dilated bowel obscures the associated malignant