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At least 1,603 records · Page 89Linked to original sources
PubMed1987

Gangliocytic paraganglioma of the duodenum: report of cytologic, histologic, immunohistochemical, and ultrastructural features of a case.

A case of gangliocytic paraganglioma of the duodenum is reported, including light microscopic, ultrastructural, and immunohistochemical characteristics. The cytologic appearance, as might be seen in fine-needle aspiration smears, indicates a neoplasm with three cellular components (epithelioid, ganglion, and spindle cells) seen histologically by light and electron microscopy.

Duodenal Neoplasms↗
PubMed1987

The effect of itazigrel and aspirin on the mucosa of the esophagus, stomach, and duodenum of normal subjects.

The effects of aspirin, itazigrel (U-53,059; a new antiplatelet drug), and placebo on the mucosa of the esophagus, stomach, and duodenum were evaluated in this double-blind, randomized, placebo-controlled study. Six normal male subjects were included in each of five treatment groups: aspirin (325 mg each morning for five doses), aspirin (325 mg tid for 12 doses), itazigrel (25 mg each morning for five doses), itazigrel (50 mg tid for 12 doses), and placebo. Aspirin and itazigrel, at all doses investigated, significantly inhibited ex vivo, ionophore (A23187)-stimulated thromboxane B2 synthesis. Collagen-induced platelet aggregation was significantly inhibited on day 3 (P = .021) and day 5 (P = .002) in both aspirin and itazigrel groups as compared with placebo. Upper gastrointestinal endoscopy was performed before the first dose of drug (day 1) and two hours after the last dose (day 5) for each subject. A rating scale was used to score the amount of mucosal damage. The baseline (day 1) endoscopic scores revealed no significant differences between groups. On day 5, neither placebo nor itazigrel treatment groups showed any significant change compared with baseline. On day 5, both aspirin groups had significantly (P less than .001) more mucosal damage than the placebo group and either itazigrel group. It is concluded that in this relatively acute study, at doses that produce comparable inhibition of platelet aggregation and platelet cyclo-oxygenase, itazigrel was superior to aspirin in terms of toxicity to the upper gastrointestinal tract.

Adolescent↗
PubMed1998

CFTR regions containing duodenum specific DNase I hypersensitive sites drive expression in intestinal crypt cells but not in fibroblasts.

We have investigated CFTR specific intestinal expression by transfection assays in mouse cultured fibroblasts and transimmortalized intestinal crypt m-ICc12 cells using the beta-galactosidase gene linked to rat CFTR non-coding regions. Two constructs were studied, one encompassing a 5.3 kb region 5' to the gene where numerous duodenum-specific DNase I hypersensitive sites (DHSs) were previously mapped and the other including a 1.3 kb 3' region in which novel DHSs had been identified. In transient transfection assays, transgenes were expressed in m-ICc12 cells but not in fibroblasts. In m-ICc12 cells, the pattern of expression of the chromosomally integrated transgenes paralleled the endogenous expression of CFTR and beta-galactosidase activity was detected in cells containing villin and forming domes. Thus, a 6.6 kb region encompassing 5' and 3' non-coding parts of rat CFTR is able to drive specific expression of a reporter gene in cultured mouse intestinal cells having kept a crypt phenotype.

3T3 Cells↗
PubMed1979

Nonchromaffin paraganglioma of the duodenum.

A benign nonchromaffin paraganglioma of the duodenum is described and compared with other reported cases. Duodenal location is extremely rare but the morphology, based on the optical microscopic pattern (Zellballen) and the ultrastructural appearance is, comparable with paragangliomas of other sites. The lack of nerve fibres and ganglion cells in this tumour, together with the absence of a positive chromaffin reaction permits us to classify it as a pure nonchromaffin paraganglioma. This finding constitutes indirect evidence of the probable existence of a paraganglion in the duodenal wall, a structure not yet demonstrated in the adult.

Duodenal Neoplasms↗
PubMed1993

Ganglioneuroma of the duodenum. Report of a case and literature review.

A 43-year-old male presented with upper gastro-intestinal bleeding. A polypoid tumor mass in the second part of the duodenum was found by endoscopic examination. Pathology revealed an extremely rare case of ganglioneuroma. The surgical local resection of the tumor was a sufficient procedure because of a lack of malignant potential. This is the fourth case since the first case was reported by Dahl et al in 1957 (1). We review the literature concerning duodenal paragangliomas, and discuss the histogenesis.

Adult↗
PubMed1986

Endoscopic diagnosis of gallstone ileus of the duodenum.

Two patients with duodenal obstruction resulting from erosion of a gallstone through the wall of the gallbladder and into the duodenum are described. Both cases were diagnosed endoscopically and successfully treated by a one-stage procedure to remove the obstruction and gallbladder and to close the fistula without complication.

Aged↗
PubMedDate not supplied

Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum.

In patients with chronic pancreatitis, common bile duct obstruction is reported in 3.2-45.6% of patients; however, only 5-10% of all patients with chronic pancreatitis require operative decompression of the bile duct. The cause of the intrapancreatic stricture of the common bile duct may be either a fibrotic inflammatory restriction, or compression by a pseudocyst. Obstruction of the duodenum is much less common than common bile duct obstruction in chronic pancreatitis occurring in less than 1-2% of patients with chronic pancreatitis. Colonic obstruction secondary to pancreatitis is very infrequent. The intrapancreatic strictures of chronic pancreatitis are characteristically smooth and tapering on endoscopic retrograde cholangiopancreatography (ERCP), but in some patients, they may have a sharp cut-off and closely resemble the appearance of carcinoma of the pancreas invading the bile duct. The natural history of these intrapancreatic strictures is variable. They may progress and be associated with cholangitis, biliary cirrhosis, common duct stones, or may remain stable for years or regress. Prior pancreaticojejunostomy is not protective against the development of intrapancreatic biliary strictures which may follow in 5-30% of patients, with most authors reporting an incidence of less than 10%. Evaluation of alkaline phosphatase, bilirubin, the presence of jaundice, or the appearance of an intrapancreatic stricture on ERCP is not predictive of whether cholangitis or biliary cirrhosis may or may not develop. The incidence of cholangitis and biliary cirrhosis in patients with intrapancreatic stricture is 9.4% and 7.3%, respectively. Laennec's cirrhosis occurs in a similar number of patients. Operation is indicated in patients with intrapancreatic strictures of the common bile duct in association with chronic pancreatitis in patients developing cholangitis, biliary cirrhosis, common duct stones, progression of the stricture, persistent high elevations of alkaline phosphatase and/or bilirubin for over a month or inability to rule out cancer of the pancreas or periampullary region. The operation of choice is choledochoduodenostomy or Roux-en-Y choledochojejunostomy to bypass the obstructed intrapancreatic portion of the common bile duct. Persistent duodenal obstruction for over 3 or 4 weeks is an indication for gastrojejunostomy. Pain is not a feature of common bile duct obstruction in the absence of cholangitis. In the presence of pain associated with chronic pancreatitis, longitudinal pancreaticojejunostomy is the operation of choice combined with Roux-en-Y choledochojejunostomy. Some of the newer operations, e.g., the Beger and Frey procedures, may make the necessity of a separate operation for biliary decompression superfluous.

Chronic Disease↗
PubMed1991

Leiomyosarcoma of the duodenum.

Leiomyosarcoma of the duodenum is a rare disease and its characteristics have been described previously in the literature. We present a case of duodenal leiomyosarcoma, which was diagnosed by several imaging techniques prior to operation. Findings of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, and angiography in this case are discussed.

Aged↗
PubMed1989

Heterotopic gastric mucosa of the duodenum mimicking a duodenal cancer.

Heterotopic gastric mucosa of peculiar shape and located in the duodenum bore a close resemblance to superficial ulcerating cancer. Radiographic survey showed a flexible lesion with a mucosal pattern resembling area gastrica. Endoscopy revealed its color to be indistinguishable from that of the normal duodenal mucosa. These may be characteristic features of this abnormality.

Adult↗
PubMed1977

Absorption of pancreatic lipase from the duodenum into lymphatics.

A significantly higher lipase activity was measured in the duodenal lymph samples of 15 dogs than in each of corresponding arterial blood plasma samples collected prior to, during and after maximal hormonal stimulation of pancreatic secretion. The result may be evaluated as a sign of pancreatic lipase absorption by the duodenum into lymphatics.

Animals↗
PubMed1976

Lesions associated with familial polyposis coli: studies of lesions of lesions of the stomach, duodenum, bones, and teeth.

The entire gastrointestinal tract and bones were examined systematically in 24 patients (10 pedigrees) in whom familial polyposis coli was diagnosed. Polypoid lesions were observed in the stomach in as high as 68.2% of the cases, and in the duodenum in 90%. Abnormalities were noted in the skeleton in 50% and in the mandible in 81.3%. The authors emphasize the possibility that familial polyposis coli is substantially the same entity as Gardner's Syndrome.

Adolescent↗
PubMed1999

Mucosa-associated lymphoid tissue lymphoma of the duodenum forming multiple polypoid lesions: report of a case.

We report herein the case of a patient found to have mucosa-associated lymphoid tissue (MALT) lymphoma of the duodenum forming multiple polypoid lesions. Endoscopic examination revealed multiple small nodules with a yellow-white, rough surface in the duodenal bulb. Histopathological and immunological findings subsequently suggested low-grade B-cell MALT lymphoma. Cytologically, MALT lymphoma is similar to multiple lymphomatous polyposis (MLP); however, this case, which involved multiple polypoid lesions, was confirmed not to be MLP.

Aged↗
PubMed1997

[Upper gastrointestinal hemorrhage caused by necrotizing cholecystitis with gallstone perforation into the duodenum].

A 68-year-old woman suffering from severe upper gastrointestinal bleeding underwent an urgent laparotomy. A necrotizing cholecystitis was found. The source of the bleeding was the eroded cystic artery. Perforation of a giant gallstone led to a fistula into the duodenum. The gallstone was removed from the distal jejunum. The patient's postoperative course was uneventful. Later on a choledochal stenosis had to be treated by stenting. One year after the procedure the patient is alive and well.

Aged↗
PubMed1999

[Results of surgical therapy of primary adenocarcinoma of the duodenum].

Between January 1983 and August 1998, a total of 18 patients (14 men, 4 women; median age 58 years, range 36-75 years) with primary adenocarcinoma of the duodenum underwent surgical therapy. Main clinical symptoms were upper abdominal pain (61%), weight loss (44%) and anaemia (38%). The tumors were resectable in 10 patients (56%), and eight Whipple operations and two segmental duodenectomies were performed. Tumor classification according to the TNM system was pT2 (n = 2), pT3 (n = 6) and pT4 (n = 2). In eight patients, local lymph nodes were tumor positive (pN1), and in two patients synchronous liver metastases were excised. The UICC stage of the resected tumors was: stage I (n = 1), stage II (n = 1), stage III (n = 6) and stage IV (n = 2). In irresectable cases (n = 8), the patients underwent palliative (n = 6) or explorative (n = 2) operations. With no operative mortality, overall morbidity was 22% (4/18). Patients' survival was 90%, 66.7% and 53.3%, respectively, at 1, 3 and 5 years after resection. None of the patients with irresectable tumors survived longer than 25 months. Survival was significantly better for the resection group (P = 0.0027). Due to the often unspecific symptoms, the diagnosis of duodenal adenocarcinoma is frequently established at advanced tumor stages, resulting in a low resectability rate. Radical surgical resection of the tumors, however, is able to provide a more favorable prognosis for duodenal carcinoma than for other periampullary tumors.

Adenocarcinoma↗
PubMed2004

Gastrointestinal stromal tumour of the duodenum in a 7-year-old boy.

We report a 7-year-old boy presenting with an acute upper gastrointestinal (GI) haemorrhage subsequently diagnosed to have a very rare duodenal gastrointestinal stromal tumour (GIST). Endoscopy, pertechnetate and red cell scans were negative. Abdominal US detected a 17-mm mass lesion of the third part of the duodenum. This was confirmed on CT and shown to be hypervascular on selective angiography. At laparotomy, a 20-mm submucosal duodenal lesion was found associated with mucosal ulceration. Immunohistochemical analysis revealed it to be positive for CD117 (c-KIT protein) consistent with a GIST. We emphasize the importance of a thorough abdominal US examination in children with GI haemorrhage and the consideration of GIST in the diagnosis after the common causes have been excluded.

Antigens, Neoplasm↗