Unusual cause of gastric outlet obstruction mimicking superior mesenteric artery syndrome: A case of infiltrative duodenal cancer arising from a choledochocele. Issue 1 (8th December 2021)

• Record Type: Journal Article
• Authors: Jang, Min Jae; Kim, Hyun Gun; Oh, Chi Hyuk; Kim, So‐Woon; You, Myung‐Won
• Is Part Of: JGH open. Volume 6:Issue 1(2022)
• Page Start: 91
• Page End: 93
• Publication Date: 2021-12-08
• Subjects: choledochal cyst -- duodenal cancer -- duodenal neoplasm -- gastric outlet obstruction -- pancreaticobiliary maljunction -- superior mesenteric artery syndrome
• DOI: 10.1002/jgh3.12695
• Languages: English
• ISSNs: 2397-9070

Abstract

Abstract: Choledochocele is a rare subtype of choledochal cyst and is associated with increased prevalence of periampullary cancers. Here, we report an unusual manifestation of infiltrative duodenal cancer arising from a choledochocele, involving superficial spreading (muscularis mucosae) of cancer cells along the duodenum causing gastric outlet obstruction, which clinically mimicked superior mesenteric artery syndrome. Histologically, wide spread of cancer cells was confirmed from periampullary region to duodenojejunal junction showing mismatch with radiologic findings, in which the cancer segment was mainly located in the distal duodenum. Clinical, radiologic, and pathologic findings are discussed with literature reviews. Abstract : The MRCP image presents the choledochocele with pancreaticobiliary maljunction. Thickened wall of choledochocele indicates cancer change. Choledochocele‐associated cancer infiltrated wide range of duodenum and caused stenosis in the distal duodenum.