Primary carcinoma of the duodenum is usually classified according to its relation to the ampulla of Vater as supra-ampullary, periampullary and infraampullary. In any of these situations, carcinoma of the duodenum is rare. In a series of 350,286 autopsies, Eger1 found an incidence of 0.033 per cent. According to Hoffman and Pack,2 carcinoma of the duodenum constituted 0.3 per cent of all intestinal carcinomas, while Eger1 stated that 45.6 per cent of carcinomas of the small intestine are found in the duodenum. Of these, 24.9 per cent were supra-ampullary, 61.9 per cent were periampullary and 13.1 per cent were infraampullary.2 If carcinomas arising from the ampulla and papilla of Vater, which should be classified as tumors arising from the biliary tract, are excluded, the percentage of tumors arising in the periampullary portion approximates that of growths arising in the supra-ampullary portion.3
In 1937 Lieber, Stewart
DUFF GL, FOSTER HL, BRYAN WW. PRIMARY CARCINOMA OF THE INFRA-AMPULLARY PORTION OF THE DUODENUM: WITH EXAMPLE OF PROBABLE ORIGIN FROM ABERRANT PANCREATIC TISSUE. Arch Surg. 1943;46(4):494–503. doi:10.1001/archsurg.1943.01220100038005
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