Abstract
Primary duodenal adenocarcinoma are rare. We report a case of a 65-year-old woman with iron deficiency anaemia that was referred to our department for endoscopic small bowel investigation. Prior to admission the patient had undergone ambulatory bidirectional endoscopy which had detected no abnormalities. Before examining the small intestine a conventional gastroscopy was performed. By using the full length of the instrument an adenocarcinoma with subtotal tumour stenosis was diagnosed located in the second portion of the duodenum. CONCLUSION: In the examination of obscure iron deficiency anaemia gastroscopy represents a cost-effective and reliable diagnostic method. In order to prevent higher costs caused by elaborate investigation of the small intestine it makes sense to tap the full potential of conventional endoscopy. Especially when performing gastroscopy the scope should always be introduced to its maximum length. Nevertheless it is a useful measure to replicate “second look endoscopy”. In the present case of primary duodenal adenocarcinoma crucial prognostic factors include radical resection, the number of examined lymph nodes and absence of metastases.
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