Abstract
An 84-year-old Japanese woman was referred to the hospital because of abdominal pain, gastric fullness, and vomiting. Plain abdominal roentgenogram showed dilation of the stomach and gastric outlet obstruction was suspected. Upper endoscopic examinations showed a protruding lesion in the gastric antrum prolapsing into the duodenum. The tumor was circumferential, endoscopically intractable, and an estimate of its nature and depth was difficult, then endoscopic resection was considered inappropriate. Barium x-ray study revealed the lobular lesion prolapsing into the duodenum. A diagnosis of gastric tumor presented with ball valve syndrome was made, laparoscopy-assisted distal gastrectomy was performed. Histopathological findings disclosed well differentiated tubular adenocarcinoma slightly invading the submucosa. An endoscopic treatment is thought to deserve considering when the early gastric cancer prolapsing into the duodenum is successfully reduced. In case of endoscopic intractability or contraindication laparoscopy-assisted distal gastrectomy is a good choice．
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