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PubMed1999

[The role of enterochromaffin-like cells in physiology and pathology of stomach and duodenum].

During recent years, gastric ECL cells have attracted much attention, mainly due to the fact that mice and rats were found to develop gastric carcinoids following lifelong treatment with blockers of acid secretion. We present the structure and functions of ECL cells and their influence on physiology and pathology of stomach and duodenum. We describe interactions of enzymes and hormones in histamine-stimulated gastric output.

Animals↗
PubMed1999

[The prognosis and prevention of the occurrence of acute ulcers and erosions of the stomach and duodenum in surgical patients].

Acute ulceration of the gastric and duodenal mucosa was found in 20.3% among 404 patients who died at the surgical department of the hospital. In 89.7% of the patients acute erosive-ulcerous lesions were localized in the gastric mucosa. In 39 patients (9.7%) acute ulcers of the stomach and duodenum complicated by bleedings or perforations were the direct cause of death. Based on results of an analysis of severity of the main and concomitant diseases as well as their complications the authors have determined the factors responsible for the appearance of the ulcers. A complex of prophylactic measures aimed at the main links of the pathogenesis of acute ulcers is proposed.

Acute Disease↗
PubMed2000

[Carcinoma of the colon invading the duodenum and pancreas].

In the submitted case-history the authors present the case of a 60-year-old woman with an extensive tumour of the transverse colon penetrating into the duodenum and head of the pancreas with an intimate relation to the upper mesenteric vein. An extensive curative en bloc resection included right-sided hemicolectomy, hemi-pancreatoduodenectomy and partial parietal resection of the upper mesenteric vein. The pathologist identified in the resected tissue a medium differentiated adenocarcinoma of the large intestine damaging the head of the pancreas and infiltrating the duodenal wall. The lymph nodes were negative and no metastatic affections were revealed. The postoperative course was without serious complications. The few cases of this type reported in the literature illustrate the possibility of successful resection and thus a substantially improved prognosis of the affected patient.

Adenocarcinoma↗
PubMed2000

Wilms' tumor with metastasis to duodenum - the first reported case in Thailand.

A case of Wilms' tumor with gastrointestinal tract metastasis of the duodenum was documented in a 22 month - old - child. She had been diagnosed with Wilms' tumor stage III, treated surgically and by radiation and chemotherapy about 1 year previously. While she was still on chemotherapy, she developed hematemesis and clinical signs of partial gut obstruction. Gastroscopy and upper gastrointestinal series showed an intraluminal vascular mass in the duodenal bulb and histologically proved to be Wilms' tumor. We believe this is the first report in the world of Wilms' tumor with gastrointestinal tract metastasis.

Duodenal Neoplasms↗
PubMed2000

[Acute gastrointestinal bleeding caused by a rare, benign tumor of the duodenum (gangliocytic paraganglioma)].

Diagnosis and treatment of massive gastrointestinal bleeding is sometimes very difficult problem in a surgical unit. Authors present a case of a 40 years old female with an atypical source of upper gastrointestinal bleeding. The origin of the bleeding was detected only by intraoperative enteroscopy. The source of the bleeding was a very rare benign tumour of the duodenum (Gangliocytic paraganglioma) which involved the papilla of Vater. During the operation resection of the pedunculated tumour was carried out, with choledochal--and Wirsungoplastyc, associated with external drainage of these ducts. According to the literature in preoperative diagnosis of this rare tumour endoscopy, angiography, and EUS are very useful. In case of malignancy, metastases radical operation-pancreatoduodenectomy--is indicated.

Acute Disease↗
PubMed2001

[Diagnosis and surgical treatment of perforated ulcers of the stomach and duodenum].

An analysis of treatment of 102 patients with perforated ulcers of the stomach and duodenum allowed to give a positive estimation of different combinations of subsidiary instrumental methods of examination (fibrogastroscopy, laparocentesis, fibrogastroscopy + laparocentesis etc.) in diagnosis of the disease. It was noted that these methods substantially improve the differential diagnostics and can be widely used in clinical practice.

Adult↗
PubMed2001

[Surgical resection of tumors in the distal duodenum].

We present six cases of successfully resected primary tumors of the distal part of duodenum (third and fourth segment). Average age of the four male and two female patients was 59 years (47-80). Distal segmental resection were performed in four, pylorus-preserving pancreatoduodenectomy in two cases. Histologically the tumors were five adenocarcinomas, and one gastrointestinal stromal tumor. This tumor causing massive bleeding. In two patients, local lymph nodes were tumor positive, and in one patient synchronous metastasis of the greater omentum was excised during a palliative resection. There was no operative mortality. During a mean follow-up period of 17 months two patients died. Our results support the fact, that radical surgical resection of these tumors, even by segmental resection, provides a more favorable prognosis for duodenal carcinoma than for pancreatic tumors.

Adenocarcinoma↗
PubMed1998

[The diagnosis and treatment of primary carcinoma of the duodenum].

OBJECTIVE: To improve the diagnosis and treatment of primary duodenal carcinoma. METHOD: The records of 18 patients with primary carcinoma of the duodenum were reviewed. RESULT: 7 cases underwent pancreatoduodenectomy: segmental duodenectomy (1), intraoperative death (1), survived 3 years (2), and survived 5 years after operation (3). 7 cases underwent gastroenterostomy or cholangioenterostomy; they died in 11 months after operation. Three cases who received biopsy only died in six months after operation. CONCLUSION: The understanding of duodenal carcinoma is the key factor for early diagnosis. The appropriate examinations are necessary for suspected patients. Once the diagnosis is confirmed, the result of surgical treatment is improved.

Adult↗
PubMed1998

A New Method to Collect Bile and Access the Duodenum in Conscious Dogs.

A novel, totally implantable catheter system that allows complete bile collection and duodenal access in conscious, freely moving dogs is described. Bile collection catheters remained patent for an average of 417 days (range, 711010 days) in eight animals which were used on study. Three animals have been used to validate the models complete collection of bile via biliary recovery of an intravenous dose of 14C-glycocholic acid, and in selected animals, parameters potentially indicative of liver damage (serum alanine aminotransferase, alkaline phosphatase, gamma glutamyltransferase, and total bilirubin levels) were within normal ranges for as many as 14 months after surgery. The eight study dogs have been used in a total of 29 studies, in which bile was successfully collected for 1248 h. The bile has been collected by using either a tethering system or a protected pouch arrangement. Compared to exteriorized catheter techniques, this system requires less maintenance and is better tolerated by the animals. The potential for a longer functional life span for individual animals, more normal liver enzymes, and the capability to selectively infuse towards the duodenum and flush the entire catheter and bile duct are other advantages of this model.

Journal Article↗
PubMed2003

[A case of advanced gastric cancer that had invaded the duodenum treated with combined chemotherapy using TS-1 and low-dose CDDP, which prevented the need for a pancreaticoduodenectomy].

A 59-year-old woman visited our hospital with a chief complaint of body weight loss and abdominal distension. Gastrofiberscopy revealed a gastric tumor that had invaded the duodenum of the second portion. The patient was treated with combined chemotherapy using TS-1 and CDDP, as it was deemed necessary to perform a pancreaticoduodenectomy for surgical curative resection. TS-1 (80 mg/m2) was orally administered for 3 weeks and CDDP (6 mg/m2) was simultaneously administered 3 times for 5 days each followed by a 2-day interval (for 3 weeks). The patient experienced grade 3 leukocytopenia. Endoscopic examination revealed partial response after chemotherapy. The patient was subjected to curative distal gastrectomy. Pathological efficacy was Grade 1b. Adjuvant chemotherapy was provided following the same regimen because of its pathological efficacy and the absence of severe adverse events. Six months after the operation, the patient was very healthy and showed no signs of recurrence of cancer. This TS-1/CDDP combination chemotherapy was suitable as neoadjuvant chemotherapy because of its rapid effect.

Administration, Oral↗
PubMed2003

Bouveret's syndrome: revisiting gallstone obstruction of the duodenum.

Bouveret's Syndrome is obstruction of the duodenum secondary to an impacted gallstone, usually without the presence of pneumobilia. With the steadily increasing life expectancy, greater numbers of these cases are being seen. Gallstones enter the gastrointestinal tract following fistula formation between the gallbladder and an adjacent hollow viscus and may cause obstruction at any point along the intestinal tract. Duodenal obstruction is the least common and represents only a very small percentage of cases. The presenting signs of nausea vomiting, abdominal cramping, and the absence of abdominal distension should alert the clinician to pathology in the proximal small bowel. The purpose of this report is to heighten the awareness of the primary care physicians, emergency room doctors, and surgeons to this diagnosis in elderly patients so that it can be included in the differential with the usual causes of gastric outlet obstruction--including ulcer disease; neoplasm; gastric volvulus; and other enteroliths, such as bezoars. Early diagnosis is critical, as these cases require urgent surgical intervention. Early resuscitation, diagnosis, and treatment are essential for a successful outcome.

Aged↗
PubMed2004

[A case of gangliocytic paraganglioma in duodenum].

Duodenal gangliocytic paraganglioma derived from neural crest is a peculiar neuroendocrine tumor. It is incidentally found during radiographic studies or due to gastrointestinal hemorrhage caused by frequent ulceration of the overlying mucosa. Most lesions are pedunculated and submucosal with distinctive histology consisting of endocrine cells, ganglion cells and spindle-shaped Schwann cells. We experienced a duodenal gangliocytic paraganglioma in a 40-year-old woman presenting with episodes of melena. Esophagogastroduodenoscopy revealed a submucosal ulcerated tumor in the second portion of duodenum and a biopsy confirmed gangliocytic paraganglioma. The tumor was enucleated through a duodenotomy. It's size was 5.5 X 3 X 1.5 cm sized and revealed positive cellular reaction for chromogranin, synaptophysin, neuron-specific enolase, and neurofilament by immunohistochemistry. The majority of the reported duodenal gangliocytic paraganglioma were of benign nature. Therefore, radical surgery or a lymph node dissection could be avoided if that disease was confirmed. However, thorough investigation for lymph node metastasis and postoperative follow-up are needed. We report the first case of a duodenal gangliocytic paraganglioma in Korea with a review of literature.

Adult↗
PubMed2004

[Lipid peroxidation in patients with multiple peptic ulcers in the stomach and duodenum].

Under the observation there were 62 patients with multiple ulcers of a stomach and duodenum from 23 till 65 years old, randomized under the sex, age and character of pathological process (sizes and localization of peptical ulcers). In all patients the parameters of lipids peroxidation were studied. The increase of intensity the peroxidation of lipids were revealed, at the expense of augmentation in a peripheric blood of the patients of concentration of a final metabolite peroxidation of lipids--malon's dialdehyde and intermediate products--dien's conjugates. The rising of a parameter hemolysis peroxidation of erythrocytes is marked also.

Adult↗
PubMed2005

Hepatocellular carcinoma directly invading the duodenum.

Recurrent gastrointestinal bleeding from hepatocellular carcinoma HCC invading the duodenum is very rare. We present a case of 50-year-old male who was admitted with a history of recurrent upper gastrointestinal tract UGIT bleeding, weight loss and anemia. The patient was known to have a chronic hepatitis C. Endoscopic examination showed grade-2 non-bleeding esophageal varices, and a large ulcerated duodenal mass partially obstructing the duodenal bulb outlet and causing recurrent UGIT bleeding. Pathological evaluation of the mass revealed HCC.

Carcinoma, Hepatocellular↗
PubMed2005

Salmonella reinfection manifesting as a fistula between the duodenum and an aortic stump pseudoaneurysm.

Despite the worldwide increase in Salmonella infections, a Salmonella infection of an aortic graft is an exceptional event. A Salmonella reinfection manifesting as a fistula between the duodenum and an aortic stump pseudoaneurysm 30 months after prosthetic excision, aortic ligature and extra-anatomic bypass for a Salmonella graft infection is a unique event. This unusual late complication described in this case report developed in 1 of the 5 patients whose Salmonella aortic graft infections have been previously reported. The reinfection causing septic aortitis responded to conventional surgery.

Aged↗