Adenocarcinoma de duodeno / Duodenal adenocarcinoma

Introducción. El adenocarcinoma de duodeno es una neoplasia infrecuente, lo que impide la existencia de grandes series que permitan extraer conclusiones sobre su diagnóstico y su tratamiento. Pacientes y método. Estudio retrospectivo (19992003) de los 5 pacientes diagnosticados de adenocarcinoma duodenal en nuestro servicio. Resultados. La edad media fue de 54 años. El 80% eran varones. Todos presentaron pérdida de peso y dolor abdominal. La localización del tumor fue: segunda (3 casos) y tercera porción (2). A todos los pacientes se les practicó una endoscopia digestiva con biopsia que informó de la presencia de adenocarcinoma. La tomografía computarizada fue la prueba diagnóstica más eficaz. El diagnóstico preoperatorio fue correcto en todos los pacientes. La técnica realizada fue duodenopancreatectomía cefálica (3 casos) y duodenectomía con resección atípica pancreática y hemicolectomía derecha (1 caso). A un paciente con metástasis hepáticas se decidió no practicar intervención quirúrgica. Dos pacientes intervenidos no presentaron ninguna complicación. Los otros presentaron vaciado gástrico lento (1 paciente) y pancreatitis del muñón, que produjo un SIRS que ocasionó el fallecimiento del paciente. La supervivencia de los pacientes intervenidos es de 60, 13 meses y 1 mes, respectivamente. Ninguno ha presentado recidiva de la enfermedad. El paciente no intervenido falleció a los 4 meses. Conclusión. El adenocarcinoma de duodeno es un tumor infrecuente asociado a diversas enfermedades. El tratamiento quirúrgico suele ser una duodenopancreatectomía cefálica. La supervivencia en los pacientes resecados es mejor que la obtenida en los tumores pancreáticos primarios (AU)

Introduction. Duodenal adenocarcinoma is an infrequent neoplasm. Consequently, there are no large series that would allow conclusions to be reached on its diagnosis and treatment. Patients and method. A retrospective study (19992003) of five patients diagnosed with duodenal adenocarcinoma in our service was performed. Results. The mean age was 54 years. Eighty percent were male. All patients showed weight loss and abdominal pain. The tumors were localized in the second portion in three patients and in the third portion in two patients. All patients underwent gastrointestinal endoscopy with biopsy, which revealed adenocarcinoma. The most effective diagnostic test was computed tomography. In all patients, the preoperative diagnosis was correct. The technique performed was cephalic duodenopancreatectomy in three patients and duodenectomy with atypical pancreatic resection and right hemicolectomy in one patient. A decision not to perform surgery was made in one patient with liver metastases. Two patients who underwent surgery showed no complications. The remaining two patients showed slow gastric emptying in one patient and pancreatitis of the stump leading to fatal systemic inflammatory response syndrome in the other. Patient survival was 60, 13 and 1 month respectively. There were no recurrences. The patient who did not undergo surgery died at 4 months. Conclusion. Duodenal adenocarcinoma is an infrequent tumor that is associated with various diseases. Surgical treatment is usually cephalic duodenopancreatectomy. Survival in resected patients is better than that obtained in primary pancreatic tumors (AU)

[Duodenal adenocarcinoma]. / Adenocarcinoma de duodeno.

INTRODUCTION: Duodenal adenocarcinoma is an infrequent neoplasm. Consequently, there are no large series that would allow conclusions to be reached on its diagnosis and treatment. PATIENTS AND METHOD: A retrospective study (1999-2003) of five patients diagnosed with duodenal adenocarcinoma in our service was performed. RESULTS: The mean age was 54 years. Eighty percent were male. All patients showed weight loss and abdominal pain. The tumors were localized in the second portion in three patients and in the third portion in two patients. All patients underwent gastrointestinal endoscopy with biopsy, which revealed adenocarcinoma. The most effective diagnostic test was computed tomography. In all patients, the preoperative diagnosis was correct. The technique performed was cephalic duodenopancreatectomy in three patients and duodenectomy with atypical pancreatic resection and right hemicolectomy in one patient. A decision not to perform surgery was made in one patient with liver metastases. Two patients who underwent surgery showed no complications. The remaining two patients showed slow gastric emptying in one patient and pancreatitis of the stump leading to fatal systemic inflammatory response syndrome in the other. Patient survival was 60, 13 and 1 month respectively. There were no recurrences. The patient who did not undergo surgery died at 4 months. CONCLUSION: Duodenal adenocarcinoma is an infrequent tumor that is associated with various diseases. Surgical treatment is usually cephalic duodenopancreatectomy. Survival in resected patients is better than that obtained in primary pancreatic tumors.