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PubMed1989

[Adenocarcinoma of the duodenum associated with skin neurofibromatosis and Caroli's disease].

A case of primary adenocarcinoma of the duodenum associated with Recklinghausen's disease and Caroli's disease provides the opportunity to review the literature. Malignant tumours of the duodenum are extremely rare and even rarer is their association with R's and Caroli's diseases. It should not be forgotten that in Recklinghausen's disease gastro-intestinal involvement is possible. Caroli's disease is diagnosed anatomopathologically. Surgical resection remains the sole satisfactory treatment when the tumour has not spread locally or at a distance. If it has, treatment must be palliative.

Adenocarcinoma↗
PubMed1978

Selective management of post-traumatic obstructing intramural hematoma of the duodenum.

Fourteen patients with post-traumatic obstructing intramural duodenal hematoma were reviewed. Seven patients underwent exploration for associated injuries. Evacuation of the hematoma was performed in two patients. Of 12 patients treated by fasting, nasogastric decompression and parenteral fluid therapy, late obstruction of the duodenum developed in one patient, and operation was required. Criteria are discussed regarding evacuation of intramural hematoma of the duodenum found at celiotomy for associated injuries. In the typical patient with an isolated intramural hematoma in whom no other indications for operation are identified, aggressive nonoperative therapy is the preferred treatment.

Abdominal Injuries↗
PubMed1987

Identification of insulin receptors in epithelial cells from duodenum, jejunum, ileum, caecum, colon and rectum in the rat.

Specific insulin binding was demonstrated in isolated epithelial cells of rat intestine, from the duodenum to the rectum. In every segment tested, insulin binding exhibited similar properties relating to kinetics and specificity and could be interpreted in terms of two populations of receptors possessing different affinities and binding capacities. Insulin receptors were unequally distributed along the intestinal tract, suggesting that the hormone may have varying importance at different points along the intestinal axis. These observations together with previous data on insulin regulation of a number of intestinal epithelial activities suggest that the pancreatic hormone may play an important role in gut physiology from the duodenum to the rectum.

Animals↗
PubMed1987

Giant villous adenoma of second portion of duodenum: case report.

Villous adenomas of the duodenum are rare. In this report the authors describe the case of a 75-year-old woman who had an extensive adenoma involving the second portion of the duodenum and ampulla of Vater. The patient was successfully managed by a pancreaticoduodenectomy. The authors describe the histopathology of the lesion and suggest guidelines for surgical consideration.

Adenocarcinoma↗
PubMed1987

[Malignant paraganglioma of the duodenum. Immunohistochemical and ultrastructural study of a case].

Paragangliomas of the duodenum are rare. Only 40 cases, most of them corresponding to benign tumours, have been published. In this study, we report a malignant paraganglioma of the duodenum with lymph node metastasis occurring in a 73 year old woman. The essential clinical manifestations which brought the patient to surgery were abdominal pain, melaena and anemia. The surgical specimen was investigated histologically, immunohistochemically and ultrastructurally. The tumour was composed of three types of cells: epithelial, gangliocytic and spindle shaped mesenchymal cells. The first contained ultrastructurally intracytoplasmic granules bound with double membranes; they stained with monoclonal antibodies against chromogranin. Gangliocytic cells stained with monoclonal N.S.E. antibodies and the spindle cells stained with S 100 protein. The spindle cells displayed ultrastructurally glial cell characteristics, containing micro-filaments of glial type. These immunological and ultrastructural features argued in favor of the neuroendocrine cell origin of this paraganglioma.

Aged↗
PubMed1987

Hydatid cyst of the head of the pancreas with spontaneous fistula to the duodenum.

Primary pancreatic hydatidosis is exceptional. Only 12 cases have been reported in Spain up to 1982. In large series of patients with hydatidosis, pancreatic involvement occurs in 0.25% of cases. We describe a 55-yr-old man who was admitted to the hospital because of fever, epigastric pain, and abdominal mass. Endoscopy, upper gastrointestinal series, and computerized tomography revealed a fistula between the duodenum and the pancreatic tumor. At surgical exploration, a primary infected hydatid cyst in the head of the pancreas communicating with the duodenum was encountered. The cyst was removed and drained. We have been unable to find in the literature a review of this form of presentation of pancreatic hydatidosis.

Duodenal Diseases↗
PubMedDate not supplied

[Post-traumatic intramural hematoma of the duodenum].

A post-traumatic intramural hematoma of duodenum in a 9 year old child was detected during exploratory laparotomy but left undisturbed. Postoperative follow up during parenteral feeding included surveillance by repeated gastrografin follow through examinations, normal transit being restored by the 12th day. Intramural hematoma of duodenum is usually due to injury and often affects male children. Symptomatology is that of upper digestive occlusion. The principal investigation should be gastro-duodenal follow through examinations with gastrografin, because of the risk of an associated perforation, to reveal possible partial or total duodenal obstruction. Conservative treatment is possible, but in case of failure or in adults surgery is indicated with evacuation of the hematoma and in some cases a gastro-jejunostomy.

Abdominal Injuries↗
PubMed1985

[Eosinophilic tumors of the duodenum and pancreas. Apropos of a case].

The authors relate about a case of tumorlike eosinophilic infiltration of the duodenum and pancreas. The preoperative workup included the traditional gastroduodenography and arteriography but also more modern investigations as echography and scanography which have not been often employed previously in this pathology. This case shows also how the involvement of the duodenum by the infiltration usually leading to carry out a cephalic duodenopancreatectomy for a benign lesion. The authors recommend conservative management if clinic, duodenographic, echographic and scanographic findings are not associated with the evident signs of carcinoma of the pancreas or of the Vater's region especially in tired patients.

Diagnosis, Differential↗
PubMedDate not supplied

Renal artery graft-to-duodenum fistula: unusual presentation of a recurrent flank abscess.

Perhaps the most devastating complication of a prosthetic vascular graft is the formation of an aortoenteric fistula. Most reports have dealt with fistulas between the aortic graft and the duodenum, although any revascularized vessel with prosthetic material can be the site of an enteric fistula. We report an unusual case in which a renal artery previously revascularized with a silk prosthetic graft developed a fistula to the duodenum 16 years later. Whether the prosthetic graft is in the aortic position or to a visceral vessel, when a fistula develops the only acceptable treatment is complete removal of the graft and revascularization with autogenous tissues, if necessary.

Adult↗
PubMed1979

Small intestinal biopsy in a patient with Crohn's disease of the duodenum. The spectrum of abnormal findings in the absence of granulomas.

The case is reported of a patient who presented with an occult anemia that was due to Crohn's disease of the duodenum. The initial evaluation revealed low serum levels of iron, folate, and carotene, and a small bowel series was abnormal but not diagnostic of Crohn's disease. Numerous small intestinal biopsy specimens were obtained from the duodenum and proximal jejunum in an unsuccessful attempt to make a diagnosis. It was shown by radiography and laparotomy 2 yr later that the patient had Crohn's disease of the proximal small intestine. This report provides a detailed analysis of the spectrum of abnormalities found by peroral mucosal biopsy in this patient. These abnormalities were patchy and included flattened mucosa, an abnormal surface epithelium which was infiltrated by large numbers of polymorphonuclear leukoyctes, increased plasma cells and polymorphonuclear leuckocytes within the lamina propria, crypt abscesses, erosions, granulation tissue, and pyloric gland metaplasia, all in the absence of granulomas. Crohn's disease should always be considered in the differential diagnosis of a proximal small bowel mucosal disease, especially when a constellation of acute inflammatory changes is present.

Adolescent↗
PubMed1984

[Incretory function of the pancreas and carbohydrate metabolism in patients with peptic ulcer of the duodenum].

Examination of 84 patients with peptic ulcer of the duodenum demonstrated that the majority of patients had alterations in carbohydrate metabolism manifested by fasting hypoglycemia, slow increase in glucose and hyperglycemia at the 180th minute during making the glucose tolerance test. The level of immunoreactive insulin (IRI) and immunoreactive glucagon (IRG) was discovered to range within wide limits, namely from low basal secretion to hyperinsulinemia and hyperglucagonemia at the end of examination with the use of the glucose and insulin tolerance tests. During making the glucose tolerance test, the changes in IRG concentration were more demonstrable. The changes in hormone secretion were recorded if the disease lasted long and did not depend on the stage of the process. IRI and IRG secretion was determined by both the glycemia level and concentration of the hormones themselves, by their mutually correlating influence and was aimed at the maintenance of glucose homeostasis in patients presenting with peptic ulcer of the duodenum.

Adult↗
PubMed1984

Villous adenoma of the duodenum. A clinicopathologic study of five cases.

Villous adenoma of the duodenum (VAD) is a rare tumor occurring predominantly in middle-aged adults and most commonly found in the second portion of the duodenum. The authors describe five cases of VAD and discuss histologic criteria for diagnosis of malignant transformation. Diagnostically, more than 90 per cent of all lesions are identified by upper gastrointestinal series and endoscopy. Treatment of choice for benign lesions is local excision, while malignant lesions should be treated with more extensive resection. In situ carcinoma in the elderly should be managed on an individual basis.

Adenoma↗
PubMed1984

Malignant leiomyoblastoma (epithelioid leiomyosarcoma) of the duodenum.

Leiomyoblastoma of the stomach is exceedingly rare. The authors report the case of a 69-year-old woman who presented with acute epigastric pain, anemia and weight loss. She was found to have a malignant leiomyoblastoma (epithelioid leiomyosarcoma) of the duodenum with lymph-node involvement. The clinical and pathological aspects of leiomyoblastoma of the gastrointestinal tract are reviewed, with emphasis on the distinctive, diagnostic histologic features. To the authors' knowledge, this is only the fourth reported case of leiomyoblastoma of the duodenum and the only case in which the tumour was malignant.

Aged↗
PubMed1981

Paraganglioneuroma of the duodenum. Report of a case with radiographic findings, angiographic findings and a review of the literature.

A 59-year old Cuban male had seven episodes of gastrointestinal bleeding. Angiographic and radiographic studies revealed a polypoid mass in the second portion of the duodenum. The mass proved to be paraganglioneuroma. A review of the literature reveals only 25 previously recorded such cases. Eighty-eight per cent of the lesions were located in the second part of the duodenum: 84% of the patients were symptomatic. The two main symptoms noted were abdominal discomfort (45.5%) and bleeding (47.6%). None of the lesions was a malignant or functional tumor.

Adult↗
PubMed1978

[Primary cancer of the duodenum].

Two clinical observations of primary carcinoma of the descending branch of the duodenum in men of 39 and 58 operated for this disease are described. Histologically the tumor was papillary adenocarcinoma. No metastases into regional lymph nodes or internal organs were found. In the patient of 39 the carcinoma of the duodenum was accompanied by papillomatous outgrowths in the opening of the pancreatic duct.

Adenocarcinoma, Papillary↗
PubMed1980

Inflammatory fibroid polyp of the duodenum.

Inflammatory fibroid polyp of the gastrointestinal tract is an unusual lesion of apparent submucosal origin but of unknown etiology. The stomach is most commonly involved with typical presentation being a rounded or oval polyp in the gastric antrum. Occurrence in the duodenum is distinctly rare since only three previous cases have been reported. We present a patient with an unusually long inflammatory fibroid polyp arising in the third portion of the duodenum.

Duodenal Neoplasms↗
PubMed1980

A villous tumour of the duodenum with malignant change in a child: A case report.

A tubulovillous adenoma of the duodenum with a predominant villous pattern in a child aged 11 years underwent malignant change, causing obstructive jaundice, and was diagnosed by percutaneous transhepatic cholangiography. Two of the patient's 9 siblings had previously died of cancer. A review of villous tumours of the duodenum is given.

Adenocarcinoma, Papillary↗