MALIGNANT TRANSFORMATION IN A DUODENAL VILLOUS ADENOMA OF THE AFFERENT LIMB OF BILLROTH-II ANASTOMOSIS

Villous adenomas arising in the duodenum and at the ampulla of Vater a re seen infrequently. Recent evidence suggests that most duodenal and periampullary carcinomas develop in preexisting adenomas. This occurre nce in a long afferent limb of a Billroth II gastroenterostomy in one patient is reported. The diagnosis was established with ''push'' enter oscopy after 3 years of recurring upper gastrointestinal bleeding and iron deficiency anemia.