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PubMed1992

Crohn's disease of the duodenum complicated by pancreatitis and common bile duct obstruction.

It is well known that Crohn's disease can involve the duodenum, but isolated secondary complications such as pancreatitis or common bile duct obstruction have only rarely been reported, and never in the same patient. Herein, we describe a patient with duodenal Crohn's disease and both pancreatitis and calculous common bile obstruction. This unusual constellation of findings was managed with percutaneous techniques in which transhepatic catheterization of the bile duct permitted balloon dilatation of the ampulla of Vater, as well as a duodenal stricture. These maneuvers resulted in passage of the biliary stone and relief of the patient's symptoms. The management of this patient may serve as a guide possibly to delay or even prevent surgical intervention in similar cases of benign enteric strictures.

Adult↗
PubMed2006

[Primary tumors of the duodenum and the small intestine in our clinical study subjects over a ten-year period].

The authors are evaluating occurrence of primary tumors of duodenum and small intestine during last 10 years (1995-2004) as a retrospective study. 13 patients were operated in this period, three of them are presented as case reports. The main clinical symptoms were bleeding and obstruction, two patients had no symptoms. To define the preoperative diagnosis of this kind of tumors is difficult and needs an essential combination of exams.

Adult↗
PubMedDate not supplied

[Gangliocytic paraganglioma of the duodenum].

Gangliocytic paraganglioma in a female of 64 years of age with stones in the gall bladder, atrophic liver cirrhosis and gastro-intestinal polyposis is described in the Russian literature for the first time. Polyps of the rectum and sygmoid were removed within 15 years. The same pathology was described by other authors. It is possible that the occurrence of paraganglioma and polyps was of genetical nature. The tumor was detected at gastroduodenoscopy. Biopsy diagnosis varied from polymorphocell liposarcoma and malignant fibrous histiocytoma. Endoscopic tumor electroexcision was complicated by intestinal bleeding that followed by an urgent laparatomy, duodenotomy and suture of the bleeding vessel in the duodenal wall. Bleeding zone in the duodenum was 3 cm from papilla Vateri. Analysis of difficulties in clinical and morphological differential diagnosis is performed.

Diagnosis, Differential↗
PubMed2006

Presentation and management of gastrointestinal stromal tumors of the duodenum.

Duodenal gastrointestinal stromal tumors (GIST) have been described primarily in isolated case reports. In order to learn more about duodenal GIST, a retrospective review of patients with GIST managed at a single institution between 2000 and 2005 was conducted. Thirty-eight GIST of the stomach and small bowel were analyzed. Eight (21%) were duodenal GIST. The median size of duodenal GIST (6.0 cm) and small bowel GIST (6.3 cm) was larger than the median size of gastric GIST (3.0 cm). The most common presentation of duodenal GIST was bleeding (50%) which was similar to other small bowel GIST (49%) but different from gastric GIST which were most commonly an incidental finding (62%). Two patients (25%) with duodenal GIST had a history of neurofibromatosis. The duodenal GIST were located in the 2nd (n = 5, 63%) and 3rd portion of duodenum (n = 3, 37%). Seven of 8 patients underwent complete resection of duodenal GIST. Pancreaticoduodenectomy was the most common operation performed (n = 5); 2 patients were treated with partial duodenal resection. No patients undergoing pancreaticoduodenectomy (n = 5) were found to have lymph node metastases. No patients received neo-adjuvant or adjuvant therapy with Imatinib. Following resection, 2 patients have recurred (12 and 48 mo.), 4 patients are without disease (1, 6, 6, and 24 mo.), 1 patient died postoperatively. Duodenal GIST are relatively rare tumors that present most commonly with gastrointestinal bleeding. Duodenal GIST are associated with neurofibromatosis. Many duodenal GIST require pancreaticoduodenectomy for complete removal.

Adult↗
PubMed1990

Carcinoid tumors of the duodenum. A clinicopathologic study of 99 cases.

Ninety-nine carcinoid tumors of the duodenum were studied. Seventy-seven patients were followed up for a mean period of 65 months, 20 tumors were autopsy findings, and two patients were unavailable for follow-up. Sixteen tumors (21%) produced metastases, all discovered initially; 3 patients (4%) died from metastatic disease (mean survival, 37 months postoperatively). Features associated with metastatic risk were involvement of muscularis propria, size greater than 2 cm, and the presence of mitotic figures. For 51 tumors, there was no correlation between immunohistochemical somatostatin and history of diarrhea, cholelithiasis, or diabetes mellitus (somatostatin syndrome). Five tumors were associated with Zollinger-Ellison syndrome and had immunohistochemical gastrin, but in the others there was no correlation between ulcer disease and gastrin positivity. Duodenal carcinoids are indolent, especially when small and localized to the submucosa. Immunohistochemical identification of somatostatin and gastrin has little clinical relevance.

Adult↗
PubMed1990

[The content of fresh material, DNA and RNA in different tissues of turkeys during growth. 2. Analysis of the myocardium, the liver, the lungs, the kidney, the pancreas, the spleen and the duodenum].

The highest DNA concentration so far recorded from organs of turkey chicken one day after hatching was the lung value of 8.61 +/- 0.20 mg/g of fresh matter, while the lowest level amounted to 1.92 +/- 0.11 mg/g and was linked to the myocardium. DNA concentrations in the spleen went up from 5.93 +/- 0.26 mg/g on the first day to 13.04 +/- 0.93 mg/g on the 224th day. The highest total amount of DNA on the 224th day was 314.6 +/- 30.23 mg/g in the liver. A high RNA concentration on the first day from hatching was 8.74 +/- 0.14 mg/g in the liver and the lowest 2.51 +/- 0.12 mg/g in the myocardium. DNA levels for the whole period under review (first through 224th days) rose by the following factors: 246.3 in the spleen, 87.4 in the pancreas, 76.6 in the liver, 60 in the duodenum, 40.5 in the kidneys, 18 in the lung, and 31.3 in the myocardium. Functional implications relating to DNA, RNA, and protein variations are discussed in some detail.

Animals↗
PubMed1991

[Pancreatitis associated with diseases of the stomach, duodenum and biliary tract].

The authors studied experience with simultaneous operations in 39 patients with coexisting diseases of the stomach, duodenum, biliary tract, and pancreas. A total of 31 operations were carried out in 14 patients with various forms of acute pancreatitis and 54 in 25 patients with chronic pancreatitis. One patient died in the immediate postoperative period from destructive postoperative pancreatitis. Simultaneous operations can be conducted under conditions of modern anesthesiological and intensive care without increasing mortality rates, which contributes to improvement of the immediate and late results of treatment of patients with concomitant digestive diseases.

Adult↗
PubMed1991

Oesophageal intramural pseudodiverticulosis with similar lesions in the duodenum.

Oesophageal intramural pseudodiverticulosis is characterized by a segmental or diffuse distribution of numerous small outpouchings varying in size from 1 to 5 mm. Review of previously described cases revealed a significant incidence of associated debilitating systemic disorders such as diabetes mellitus, malignancy, alcoholism and tuberculosis. No record could be found in the literature of a similar process occurring in other parts of the gastro-intestinal tract. A case is reported of a severe alcoholic who, on a barium swallow, in addition to the changes of oesophageal intramural pseudodiverticulosis, presented with a large duodenal ulcer and similar outpouchings in the first and second parts of the duodenum.

Alcoholism↗
PubMed1991

Leiomyoma of the duodenum--a case report.

A 36-year-old man with anemia due to gastrointestinal bleeding, diagnosed to have a leiomyoma of the duodenum, is described. The conventional barium meal study and gastroendoscopy were useful for diagnosing the lesion. More invasive radiological methods, such as abdominal angiography and technetium-99m scintigraphy failed to detect the tumor. Early diagnosis and resection of the tumor would result in a good prognosis.

Adult↗
PubMedDate not supplied

[Vascular compression of the duodenum].

The acute vascular compression of the duodenum is a well-recognized clinical entity, characterized by recurrent vomiting, abdominal distention, weight loss, post prandial distress. The cause of compression is considered to be effect produced as a result of the angle formed by the superior mesenteric vessels and sometimes by one of its first two branches, and vertebrae and paravertebral muscles, when the angle between superior mesenteric vessels and the aorta it's lower than 18 degrees we can saw this syndrome. The duodenojejunostomy is the best treatment, as well as in our patient.

Adolescent↗
PubMed1991

[Diverticula of the duodenum. Our experience in 27 cases].

After the colon, the duodenum is the most common site of diverticula. The Authors describe their experience of the surgical treatment of 27 patients suffering from duodenal diverticulosis. Treatment of diverticula was associated with therapy for more severe underlying pathologies in 23 cases. Four cases underwent elective treatment for symptomatic diverticulosis. No major complications or increase in the average time spent in hospital were observed in either group.

Adult↗
PubMed1991

[Focal nodular hyperplasia of the liver associated with cardial achalasia, situs viscerum inversus and gastric mucosal ectopia in the duodenum].

The authors describe the clinical case of a young woman with a focal nodular hyperplasia (FNH) of the liver associated with achalasia of the cardia, situs inversus totalis and ectopy of gastric mucosa in duodenum, and discuss the etiopathogenic aspects of the hepatic lesion. The frequent association of the FNH with various malformations, as the literature and this case-report relate, seems to confirm the hypothesis of a dysgenetic hamartomatous origin. Therefore any liver single mass in a patient with a malformative syndrome must rouse the suspicion of a FNH.

Adult↗
PubMed1991

Endoscopic findings in carcinoid tumor of the duodenum.

The endoscopic findings in six patients with carcinoid tumor of the duodenum were analyzed. Radiographic and endoscopic examinations revealed a smooth and round elevation (measuring 5-20 mm in diameter) in the duodenal bulb. In three patients, the lesion was accompanied by an irregularly shaped erythematous depression, a characteristic endoscopic finding of this tumor. Because the endoscopic forceps biopsy technique led to an accurate diagnosis, we wish to stress the clinical value of the endoscopic modalities.

Adult↗
PubMed1990

[Adenocarcinoma of the duodenum. 17 cases].

Seventeen cases of duodenal adenocarcinoma are reported and compared with cases from the literature. Ten tumours were located in the second part of the duodenum, 9 were around the hepatopancreatic ampulla, 4 were above and 4 below this ampulla. Four tumours (23 per cent) had limited intramural expansion (Dukes' stage A or B) and 6 (35 per cent) involved the lymph nodes. The major clinical signs were loss of weight (11 cases), signs of obstruction (9 cases), bleeding (6 cases) and jaundice (6 cases). The paraclinical examinations that were determinant for the diagnosis were gastroduodenal radiographic study (16 cases) and endoscopy with biopsy (9 cases). Computerized tomography was useful for preoperative evaluation. The respective values of these examinations for early diagnosis and excisability of these tumors are discussed. All 17 patients were operated upon: 11 (64.7 per cent) underwent radical excision, 5 had duodenal bypass and 1 had exploratory laparotomy. The overall operative mortality rate was 5.8 per cent, with no deaths for bypasses and excisions. Mean survival after bypass was 5 1/2 months. The one year survival was 63.5 per cent in 5 patients with excision and 83.3 per cent in 6 patients with cephalic duodenopancreatectomy, but none of these patients survived for more than 5 years.

Adenocarcinoma↗
PubMed1990

Endocrine tumors of the duodenum and upper jejunum. A study of 33 cases with clinico-pathological characteristics and hormone content.

Thirty duodenal and three upper-jejunal endocrine tumors are reported. Clinical manifestations included: a) the Zollinger-Ellison syndrome (10 cases); b) peptic ulcer disease in which hypergastrinemia was not documented (3 cases); c) cholestasis or cholelithiasis (4 cases); d) abdominal pain (4 cases); e) gastro-intestinal bleeding (1 case); f) celiac sprue (1 case). Ten further tumors were discovered incidentally, at autopsy or in pathological specimens after gastrectomy or duodenopan-createctomy. Histological pattern was trabecular in 19 cases, insular in 2 and mixed in ten cases. Two cases were typical ganglioneuromatous paragangliomas. All tumors were examined immunohistochemically. Twelve tumors contained gastrin, four somatostatin, six both of these peptides, one serotonin, two both gastrin and serotonin, and two tumors contained gastrin, serotonin and somatostatin. Ganglioneuromatous paragangliomas combined somatostatin and/or pancreatic polypeptide containing endocrine cells with protein-S100-positive Schwann cells. In four tumors no peptide or amine was demonstrated. Gastrin cell tumors (63.6% of our cases), both functionally active (gastrinomas) and clinically silent, predominated in the proximal duodenum, while somatostatin cell tumors (15.1%) and paragangliomas were mostly found in the periampullary region. Two tumors were classified as malignant on the basis of lymph node metastases, and both were jejunal gastrinomas associated with Zollinger-Ellison syndrome. Two somatostatin cell tumors had manifestations of von Recklinghausen's disease.

Adenoma, Islet Cell↗
PubMed1990

[A pseudosarcoma of the duodenum].

Pseudosarcoma is a rare malignant neoplasm composed of both carcinomatous and sarcomatous elements. It occurs most frequently in the uterus. When located in the gastrointestinal tract the lethality is almost 100% one year after the diagnosis. Clinical observations and radiological findings in a 52-year old patient with pseudosarcoma of the duodenum are presented in this report.

Carcinosarcoma↗