North Texas Research Forum 2024



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North Texas


Medical City Arlington


Internal Medicine

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Internal Medicine | Medicine and Health Sciences | Neoplasms


Adenocarcinoma of the duodenum is a rare but aggressive malignancy making up less than 0.5% of gastrointestinal cancer cases (Tuan et al., 2023), (Cloyd, 2016). We present a rare case of invasive adenocarcinoma of the first part of the duodenum and major papilla that required complex biliary stenting. A 72-year-old male was admitted to our hospital for further workup of gastrointestinal bleeding and 30-pound weight loss. Through imaging it was noted he had lymphadenopathy and biliary dilation. Patient underwent multiple gastrointestinal procedures and was endoscopically found to have a circumferential mass within the ampulla. After unsuccessful cannulation during endoscopic retrograde cholangiopancreatography, a transmural duodenal-common bile duct stent was placed to improve obstruction. Fine needle aspiration of the mass showed pathology significant for primary duodenal carcinoma for which he underwent chemotherapy. While undergoing chemotherapy, it was noted that patient’s original stent was clogged. Patient subsequently underwent complex ampullary stent exchange procedures including a percutaneous transhepatic-transmural duodenal rendezvous maneuver. This case report will discuss a rare case of invasive adenocarcinoma of the duodenum that required complex biliary stent exchange and novel stenting method. Due to the rarity of duodenal cancers and the complexity of the stenting procedures, our case report will help add to the field to better understand this subject.

Original Publisher

HCA Healthcare Graduate Medical Education

A Rare Case of Invasive Adenocarcinoma of the Duodenum and a Bovel Biliary Stent: A Case Report



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