The American Journal of Digestive Diseases

, Volume 5, Issue 3, pp 264–273 | Cite as

Carcinoma of the pylorus simulating benign duodenal obstruction

  • Charles H. Brown

Summary and conclusions

Carcinoma of the pylorus may simulate benign duodenal obstruction. Three cases that illustrate some of the pitfalls in the differential diagnosis of duodenal ulcer or pyloric carcinoma are presented. In case 1, medical treatment brought relief of the obstruction, but the correct diagnosis was delayed four and a half months because of inadequate visualization in the progress roentgenologic examinations of the pylorus and the duodenal bulb, and of the lack of cooperation of the patient. In case 2, medical treatment brought no relief of an obstruction associated with a presumed duodenal ulcer of five years' duration, and pyloric carcinoma was found at operation. In case 3, medical treatment brought relief of an obstruction in a patient with a history of duodenal ulcer of 40 years' duration, but the progress roentgenologic examination suggested pyloric carcinoma, which was confirmed at operation. Complete reliance cannot be placed on a history of duodenal ulcer. Persistent obstruction despite intensive medical treatment is suggestive of pyloric carcinoma and makes operation advisable. The relief of the obstruction, conversely, does not rule out pyloric carcinoma.

It is urged that the physician who is medically treating a patient with pyloric obstruction assume the responsibility of making satisfactory progress roentgenologic examinations of the stomach to establish the presence or absence of pyloric carcinoma. Adequate findings usually can be obtained after 14 days of intensive medical treatment.


Public Health Carcinoma Differential Diagnosis Medical Treatment Duodenal Ulcer 
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Copyright information

© Paul B. Hoeber, Inc. 1960

Authors and Affiliations

  • Charles H. Brown
    • 1
  1. 1.From the Department of GastroenterologyThe Cleveland Clinic Foundation, and The Frank E. Bunts Educational InstituteCleveland

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