case_images: PMC10949927_01
case_images: Upper endoscopy. Evidence of food remains extracted orally with Roth Net. In distal second duodenal portion, erythematous lesion with jagged edge is observed, that narrows the lumen.
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case_images: PMC10949927_01_0102-6720-abcd-37-e1796-gf1.jpg
case_images: f1
case_images: The upper digestive endoscopy (UDE) showed chronic atrophic gastritis with areas of metaplasia, and in the second duodenal portion, distal to the papilla, a stenosing erythematous lesion with jagged edges, accessible with difficulty (Figure 1).
case_images: Biopsies from upper digestive endoscopy. Moderately differentiated papillary and tubular adenocarcinoma, infiltrating duodenal mucosa.
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case_images: f2
case_images: The biopsies revealed moderately differentiated papillary and tubular adenocarcinoma, infiltrating the duodenal mucosa (Figure 2).
case_images: Computed tomography of abdomen and pelvis with contrast. A, B (axial section) and C (coronal section): concentric parietal thickening in the first portion of the duodenum with no signs of obstruction.
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case_images: f3
case_images: In addition, the CT showed slight dilation of the bile duct up to 9 mm, and the common bile duct with progressive narrowing (Figures 3A, 3B, and 3C).