[A case of duodenal invasion due to recurrent gastric cancer with obstructive jaundice treated by chemotherapy].

A 64-year-old man was admitted to our hospital with complaints of jaundice, upper abdominal distension and pain. He had a history of laparoscopic-assisted distal gastrectomy for gastric cancer about 11 months ago. The stage was IB and pathological examination was poorly differentiated adenocarcinoma. The upper gastrointestinal fiberscope showed a continuous duodenal stenosis between an anastomotic region and the third portion. The pathological diagnosis was recurrent of gastric cancer. The abdominal CT scan showed a dilatation of bile duct due to duodenal invasion. After percutaneous transhepatic cholangio drainage (PTCD) and jejunotomy, the chemotherapy with low-dose CDDP and 5-FU followed by weekly paclitaxel was performed. The stenosis of duodenum and dilatation of bile duct were improved. The patient lived for 8 months after chemotherapy. It is important to understand that gastric cancer diagnosed poorly differentiated adenocarcinoma pathologically sometimes occurs duodenal invasion and obstructive jaundice.