SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
By intensive investigation relatively often small lipomas in the duodenum can be found at post mortem examination. They are harmless and develop in the submucosa and grow in a polypous form into the lumen. Lipomas seem to be the most frequent among the benign mesenchymal tumours.
Forty-three cases of regional enteritis of the duodenum were found in the world literature. Regional duodenitis is relatively uncommon; in one large series of 600 cases of regional enteritis only three involved the duodenum.At the University of Alberta Hospital, in a three-year period (1962 to 1965), the authors encountered five patients with regional duodenitis, demonstrating a spectrum of clinical, radiologic and pathologic characteristics of this disease. The description of these patients brings the world's total to 48 reported cases.Two of these patients had symptoms of severe duodenal obstruction and were relieved by bypass procedures and vagotomy; one required surgery because of co-existent obstructive ileal disease: and two patients have improved on corticoids and salicylazosulfapyridine without surgery.In our experience treatment with corticoids and salicylazosulfapyridine is beneficial.Four of the five patients remain in a state of mild to moderate nutritional impairment and have evidence of intestinal malabsorption. In the fifth case the period of followup is too short to permit assessment.
A case of a neurinofibroma in the distal part of duodenum is reported by the author. It has caused a so-called blind resection of the stomach by Billroth II-type as the result of not clarified bleeding. But after restoration of the duodenal transit by the procedure reverting into Billroth I-operation there was the possibility of the accurate diagnosis of the origin of bleeding by means of gastroduodenoscopy and X-ray examination by duodenal hypotension and with it the definitive healing.
Five observations of calculous stenosis of the duodenum after cholecysto-duodenal fistulization are reported. Four times, the pre-operative diagnosis has been made out by an opaque gastro-duodenal transit. The treatment is usually surgical, and its modalities are discussed about, but it is pointed out that the endoscopic duodenal desobstruction on patients running high operative risks presents a real interest.
The authors report on three cases of benign neurogenic tumors of the duodenum, two of which degenerated. They discuss the difficulties involved in diagnosis and treatment. In one case, the tumor was simply excised. In the two cases of malignant tumors, the excision was wider because of extensions to the liver or colon. Postoperative chemotherapy was applied in both cases, but to little effect as the two patients died within two years of the operation.
Seventeen years after a Billroth II gastric resection for duodenal ulcer had been performed, two large polypoid tumors were found in the gastric stump (outside the stomal area) and in the duodenal stump of a 69-year-old man. Histologically the neoplasms were tubular adenomas with small focal carcinomatous changes restricted to the gastric tumor. A distinctive feature of both tumors was the occurrence of three major cell populations segregated into two different types of neoplastic epithelium: one with columnar mucous cells containing gastric type mucins and mixed with a large number of argyrophil endocrine cells and the other with large, pleomorphic cells containing immunoreactive lysozyme and intestinal type mucins. In the absence of any evidence of generalized gastrointestinal polyposes, it is suggested that both tumors originated from the gastric mucosa (of heterotopic origin in the duodenum) and that the second type epithelium may represent a particular, and up to now unrecognized, type of intestinal metaplasia.
A 56-year-old man presented with obstructive jaundice was found to have diffuse cystic glandular malformation of the second part of the duodenum, in association with adenocarcinoma of the periampullary area. Comparison of the pathological findings with myoepithelial hamartoma and diffuse cystic glandular malformation of the stomach reveals resemblances and differences.
A patient with multiple villous adenomas of the duodenum is described. Endoscopy plays an essential role in the management of these neoplasms. If no evidence of invasive malignancy is found on multiple endoscopic biopsies, wide local excision is the initial procedure of choice. Invasive malignancy found in either the endoscopic biopsy or the surgical specimen is indication for pancreaticoduodenectomy.
The examination of 146 patients with the ulcer disease of the stomach (26 cases) and duodenum (120 cases) has established that the ulcer was colonized by different microbes and their associations in 81,5% of cases. The colon bacillus was found almost in half the cases. The application of corresponding antibiotics in the pre- and post-operative treatment gave better immediate results.
Two cases of villous adenoma of the duodenum are reviewed. Surgical resection is complicated by the local anatomy but in 80 per cent of the patients may be limited to submucous resection via lateral duodenotomy. The two cases are compared to the 50 published case reports.
A case of villous polyps of the duodenum is reported, world-wide series also being considered. The various symptomatologies and percentages of malignant transformation and localization are described and stress laid on the superiority of endoscopy to radiography owing to the fact that it gave: 1) exact site and nature diagnosis of the lesion during the haemorrhagic phase; 2) exact histological and topographical diagnosis, following the haemorrhage, paving the way to the subsequent surgery.
Paraganglioma of the duodenum is a tumor which typically occurs in the ampullary region and which has been regarded as benign. This patient, as well as most of the 25 similar cases previously described, presented with upper gastrointestinal bleeding. Diagnosis may be elusive, particularly when a Billroth II anastomosis has been done previously. Careful identification of the ampulla is mandatory to ensure safe excision of the tumor. The possibility of multicentricity in these tumors heightens the necessity of distinguishing them from ampullary carcinoma at operation.
The sign of Leser-Trélat is a rare cutaneous manifestation of internal malignancy. Although adenocarcinoma is the most common malignant neoplasm associated with the sign of Leser-Trélat, we report what we believe to be the first case of adenocarcinoma of the duodenum associated with this sign. Because of the location of the tumor, we considered the possibility that the skin changes may be due to increased levels of epidermal growth factor (EGF) in this patient. However, no alteration in urine EGF levels was found.
Primary malignant lymphoma located in the duodenum is a rarity. A case where such a tumor made its debut with massive gastro-intestinal bleeding is reported here. Treatment consisted of emergency subtotal pancreaticoduodenectomy followed by antineoplastic chemotherapy for one year. At one year follow-up examination there were no signs of recurrence.
Two cases of primitive malignant tumour of the duodenum are reported, with exclusion of neoplasias of the periampullar region. Such restriction makes this pathology rather rare. The clinico-diagnostic aspects are analysed and, for purpose of radicality, a comparison is made between two surgical techniques: duodenocephalopancreatectomy, possible for any localisation, and intestinal shortening with duodenal-jejunal resection for tumours of the 3rd and 4th portions.
Two cases of duodenal villous adenoma are reported, bringing the total reported in the world literature to 51. The tumors are of importance despite their rarity because of the frequency of focal or occult malignant changes in the tumors, the nonspecific symptoms and radiographic findings and the potential surgical complications. Therefore, atypical lesions of the duodenum should be investigated endoscopically and all duodenal villous tumors should be surgically resected. Local excision is usually adequate treatment even when microinvasive cancer or carcinoma in situ are present.
The mode of onset, and clinical, radiological, and endoscopic findings in 107 cases of digestive hemorrhage are described, as well as variations in the period elapsing between onset and surgical intervention. Indications for surgery and the results obtained are analyzed. Operation consisted of subdiaphragmatic truncal vagotomy in 74 cases (followed by pyloroplasty in 68 and gastroenterostomy in 6 cases), gastroduodenal resection in 23 cases (with subsequent gastrojejunal anastomosis in 17 and gastroduodenal anastomosis in 6 cases), resection for exclusion operation as described by Finsterer in 8 patients, and highly selective vagotomy with pyloroplasty in 2 cases. Hemorrhage reoccurred in 12 patients (11.2 p. cent), after vagotomy and pyloroplasty in 11 patients (with 3 deaths), and one case after resection. Of the 8 early relapses, 4 were treated medically, leading to 2 recoveries and 2 deaths, the other 4 patients being treated by gastroduodenal resection, with subsequent recovery in 5 cases and one death. The 4 patients with late recurrences were successfully treated medically (2 cases) or surgically (2 cases). Though Weinberg's operation can still be considered as the basic operation in patients with hemorrhage from ulcers on the posterior in patients with hemorrhage from ulcers on the posterior wall of the duodenum, immediate gastric resection is still a valid procedure for large ulcers with thickened walls. Early relapse of hemorrhage after Weinberg's operation should be treated by resection.
Gastric salt-acid secretion was studied in three comparative patient groups with gastric ulcer, endoscopically confirmed, combination of gastric and duodenal ulcers. In the patients with double localization of the ulcer (stomach and duodenum) - hyperacidity was determined after pentagastrin stimulation. Acid-salt secretion was higher than that of the patients with gastric ulcer and was close to the secretion of those with duodenal ulcer, being but with a high standard deviation, necessitates consideration to be given to each concrete case of treatment. No discrepancy in the volume of gastric secretion before meals was established, thus impugning the role of pylor stasis in the genesis of secondary gastric ulceration. The incidence of atrophic gastritis in case of gastric and double ulcer is almost identical, hence attention is paid to the duodeno-gastric reflux as an eventual cause for damaging gastric mucosa with its successive ulceration in the patients with duodenal ulcer of many years. That is the reason, drugs enhancing the resistance of gastric mucosa as well as methoclopramid intake are proposed additionally to the drugs, neutralizing or blocking the gastric acid-salt secretion.
Refine your search to explore more results.