Primary carcinoma of the duodenum.

As the only hope for patients with malignant disease of the duodenum depends upon early diagnosis and prompt and adequate operation, suspicion must be alert even though the condition is relatively rare. The incidence is highest in persons between 50 and 70 years of age, and two or three times as high in males as in females. The onset is insidious. The patient usually gives a history of fairly good health and no other related symptoms until about a year before diagnosis. Early symptoms are loss of appetite, loss of weight, and moderate pain in the right upper quadrant of the abdomen, sometimes associated with epigastric fullness which is relieved by belching. Vomiting and constipation are late symptoms. There may be occult blood in the stools, moderate anemia in some cases, and frequently jaundice. The radiological findings are irregularity of the mucosal pattern in the region of the tumor and often constriction of the involved portion of duodenum.A report is made herein upon four cases of primary carcinoma of the duodenum observed at one hospital in a period of only a little more than two years.