Cancer of the duodenum is almost unknown , and this local immunity when compared to the frequent occurrence in the contiguous stomach is an intriguing feature of this strange disease. Cancer of the whole small intestine is also remarkably rare, and this relative immunity is thought to be due to the fast transit times of ingested foods with their associated carcinoges, minimizing any local exposure. This form of cancer often announces itself quite abruptly as an acute intestinal obstruction with frequent colicky abdominal pains, rapidly increasing abdominal distension, and profuse vomiting a situation requiring emergency surgery, during which this comparatively rare diagnosis is established. The surgical problem is handled by carrying out a wedge resection.
This stand art operative procedure remove the tumor, an adequate margin of healthy intestine above and below it, and a wedge of the mesentery containing the related lymph nodes. If the primary tumor is resectable it must be removed or at least bypassed to relieve the urgent symptoms. A variety of histological types of tumor occur in this area, and none can be treated by radiotherapy. If the tumor is a carcinoma and liver or other irresectable metastases are present, chemotherapy is of only dubious value. If however, the tumor is a sarcoma, and in particular a lymphosarcoma, chemotherapy can prove to be highly beneficial.