Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions

Douglas G. Adler, MD

Question 21: A 70-Year-Old Man With Pancreatic And Liver Cancers Develops Gastric Outlet Obstruction Due To A Mass Compressing The Mass Proximal Duodenum. What Treatment Options Exist For This Situation? (continued)

Todd H. Baron, MD

Because the head of the pancreas lies adjacent to the medial wall of the duodenum, it is not surprising that, as cancer of the pancreatic head progressively enlarges, it often encases and/or extrinsically compresses the duodenum. This patient has malignant gastric outlet obstruction (GOO), a complication that almost always develops late in the course of pancreatic head cancer, often in the preterminal phase of the disease. Patients with GOO almost always have unresectable disease. Indeed, liver metastases are seen on computed tomography (CT) scan, and therefore the patient clearly has…