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PubMed1990

[Computed tomographic detection of a polypous form of eosinophilic gastroenteritis in the duodenum].

The eosinophilic granuloma of the intestine is a relatively uncommon lesion which is unrelated to the eosinophilic granuloma of lung or bone. We describe one case of this disease in the duodenum evaluated by hypotonic duodenography and computed tomography (CT). The radiographs showed sharply delineated circular intra-luminal filling defect. CT demonstrated a homogeneous soft tissue mass and excluded an extraluminal extension of the lesion. Histological examination is essential for confirming the diagnosis.

Aged↗
PubMed1990

Effect of flurbiprofen and 16,16-dimethyl prostaglandin E2 on gastrointestinal tumorigenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine in rats: glandular epithelium of stomach and duodenum.

The effect of an exogenous synthetic prostaglandin analogue, 16,16-dimethyl prostaglandin E2 (16,16-dm-PGE2), as well as the effect of endogenous prostaglandin synthesis inhibition by a cyclooxygenase inhibitor, flurbiprofen, on chemically induced gastric carcinogenesis has been investigated in rats. Carcinogenesis was induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG; CAS:70-25-7). Animals were divided into six groups: Group I, treatment with MNNG alone; Group II, treatment with 16,16-dm-PGE2 plus MNNG; Group III, treatment with flurbiprofen plus MNNG; Group IV, treatment with 16,16-dm-PGE2 alone; Group V, treatment with flurbiprofen alone; and Group VI, controls. Treatment with high doses of MNNG resulted in rapid development of malignant tumors originating from the glandular epithelium of the stomach and duodenum in animals of all groups receiving the carcinogen. The first gastric adenocarcinoma infiltrating the muscularis proper was detected after 139 days in an animal treated with a combination of MNNG and flurbiprofen. The incidence of infiltrating adenocarcinoma and the incidence of all neoplastic lesions of the glandular stomach were both significantly higher in animals treated with a combination of MNNG and flurbiprofen compared with treatment by MNNG alone or in combination with 16,16-dm-PGE2 (P less than 0.05 and P less than 0.001). The difference in tumor incidence between the last two groups was not significant. The first duodenal adenocarcinoma was detected on Day 114 in another animal of the group treated with MNNG plus flurbiprofen. When compared with the group treated with MNNG plus 16,16-dm-PGE2, significantly more animals developed duodenal adenocarcinoma when treated with MNNG plus flurbiprofen (P less than 0.005) or with MNNG alone (P less than 0.05). Results of this study indicate that inhibition of endogenous prostaglandin synthesis favors development of adenocarcinoma in the glandular stomach of rats. Vice versa, the addition of an exogenous prostaglandin analogue inhibits the development of duodenal adenocarcinoma. This protective effect of prostaglandins may be due to an increase of the thickness of the mucus gel covering the glandular epithelium, thereby preventing access of carcinogen to the mucosa.

16,16-Dimethylprostaglandin E2↗
PubMed1990

[Gangliocytic paraganglioma of the duodenum. Case report with immunocytochemical characterization].

Described in this paper are histological, electron-microscopic, and immunocytochemical findings recorded from a duodenal gangliocytic paraganglioma in a 21-year old man. The sessile polypoid tumor consisted of epithelial cells, neuroid spindle cells, and gangliocytic elements. Neurosecretory granules were detected by electron-microscopy in the epithelial cells. The neuroid spindle cells exhibited the ultrastructural feature of Schwann cells. The tumor was immunocytochemically characterized by the S-100-reactivity of the spindle cells and numerous PP-reactive epithelial cells. Gangliocytic paragangliomas of the duodenum are of benign behaviour and should be removed by local excision.

Adult↗
PubMed1990

[Combined operations in diseases of the stomach and duodenum].

The article generalizes the experience in treating 137 patients with diseases of the stomach and duodenum. The largest group included 82 persons with peptic ulcer; 45 had carcinoma of the stomach; 5 had benign tumors of the stomach, and 5 persons had chronic duodenal obstruction. The most common concurrent disease was cholelithiasis (102 patients), it was diagnosed before the operation in 70% of patients with peptic ulcer and in 85% of those with carcinoma of the stomach. Among the less predominant diseases were abdominal hernias (12 patients), cysts of various localization (7), varicosity (3), chronic appendicitis (3), atherosclerosis obliterans (2), ect. Organ-preserving operations were carried out as the main stage of surgery in most patients with peptic ulcer. The nature of the simultaneous operations corresponded to the concomitant surgical diseases. Most of the operations (125) were performed through a median laparotomy approach; superior median laparotomy was mostly resorted (115 patients). Four (2.9%) patients died after the operation. It is pointed out that patients with gastroduodenal diseases must be thoroughly to reveal concurrent surgical diseases.

Adult↗
PubMed1990

[Intramural hematoma of the duodenum as complication in anticoagulant therapy. Diagnosis and therapy].

We report the history of a 68-year-old man who has been hospitalized for an aortic valve endocarditis. The patient was under full anticoagulation therapy because of an artificial aortic valve (Omnicarbon 23 mm). During hospitalization the patient developed a subacute abdomen accompanied by upper gastrointestinal tract hemorrhage. At endoscopy and radiology an intramural hematoma of the duodenum was found. The typical findings of intramural hematoma such as abdominal X-ray, ultrasound, CT scan, selective small bowel transit and endoscopy are presented and the history as well as therapeutic modalities discussed.

4-Hydroxycoumarins↗
PubMed1990

Technical aids in surgery. Gastroduodenostomy for the "difficult" duodenum.

Many techniques have been devised for the safe closure of the 'difficult' duodenal stump after Billroth II gastrectomy. It is suggested that, in the presence of a 'difficult' duodenum and when gastrectomy is unavoidable, gastroduodenal anastomosis obviates the potential hazards of the high-risk duodenal stump.

Duodenostomy↗
PubMed1990

[Villous adenoma of the duodenum. Presentation of a case].

A case of villous adenoma of the duodenum is presented; the wide implantation of the tumor imposed a cephalic duodenopancreatectomy. The endoscopic examination plays an important role in the diagnosis of these tumors, but it frequently; does not exclude the possibility of a malignant lesion, this fact renders difficult the choice of adequate treatment. We review the surgical approach of these tumors, which ranges from local resection to duodenopancreatectomy, depending on the pathological study and intraoperative findings.

Adenoma↗
PubMed1990

[Comparison of biphasic radiologic stomach and duodenum studies with fiber endoscopy for the diagnosis of peptic ulcer and stomach carcinoma].

In a prospective, blind study of 385 patients with dyspepsia, the diagnostic value of biphasic radiological examination of stomach and duodenum was compared with endoscopy. The patients were examined for presence of peptic ulcers and gastric carcinomas. No golden standard being available, kappa values were calculated for the comparison. The kappa values were 0.67 and 0.77 for gastric and duodenal ulcers, respectively; for gastric carcinomas the value was 0.91. These values indicate good agreement. The sensitivity and specificity of both methods were high; a lower sensitivity of radiological examination for duodenal ulcers was accounted for by ulcers smaller than 5 mm; for larger ulcers, the sensitivity and specificity of both methods were practically the same. It is concluded that the two methods are of equal value for the diagnosis of peptic ulcers and gastric carcinomas. Endoscopy offers the major advantage that biopsy samples can be taken for histological examination or culturing. The biphasic radiological examination, on the other hand, is cheaper and often better tolerated by the patient.

Adolescent↗
PubMed1989

True clinical entity of vascular compression of the duodenum in adolescence.

Thirteen pediatric patients were diagnosed with superior mesenteric artery syndrome (SMAS) at our institution between 1974 and 1986. Four were successfully treated with nasojejunal feedings only, and nine underwent a derotation procedure designed to alleviate the problem of compression of the duodenum by the superior mesenteric artery. Of the nine patients who were operated upon, only one required a gastrojejunostomy to bypass a persistent obstruction. Therapy was aimed specifically toward the problem of duodenal occlusion at the mesenteric root. Because this therapy was successful in all of the patients, we conclude that SMAS exists as a treatable entity and must be considered in any adolescent patient who presents with symptoms of obstruction of the upper part of the gastrointestinal tract and failure to thrive.

Adolescent↗
PubMed1989

[Primary adenocarcinoma of the duodenum].

Two cases are presented of primitive adenocarcinoma of the duodenum diagnosed and treated in the General Surgery Department of General Hospital of Elche (Spain) during the 10 years of its existence. The two patients were women, one a 45-year-old who consulted for pain, epigastric discomfort and melenas, and the other a 76-year-old who consulted for paraneoplastic syndrome and a palpable mass in the right lower quadrant. Radical resection was performed, with cephalic duodenopancreatectomy in the first case and atypical local resection of the first and second duodenal portions, gastric antrum and gallbladder in the second case. Six and 4 years after operation, respectively, the two patients are alive and asymptomatic. We comment the most important aspects of this rare disease in relation to the pecularities of our cases. We insist on the appropriateness of surgical resection as an effective therapeutic option.

Adenocarcinoma↗
PubMed1989

[Computed tomography of the esophagus, the stomach and the duodenum. Review of methods and results].

Computed tomography (CT) of the esophagus, the stomach and the duodenum allows characterization of some lesions: lipomas, cysts and duplications, recent haematomas, vascular anomalies. CT is particularly used for the extramural staging of neoplasms: despite important limitations, CT may be useful as staging test to identify a subgroup of patients with definitive metastases or local invasion who therefore have unresectable tumors. CT is helpful for the staging of lymphomas. The importance of this staging classification is reflected in differences in treatment and prognosis. CT is also useful for the follow-up after treatment, the diagnosis of recurrence and postoperative complications.

Esophageal Neoplasms↗
PubMed1989

[Ways of reducing mortality in perforated ulcer of the stomach and duodenum].

Based on an analysis of lethal outcomes in 20 of 326 patients with perforated ulcers of the stomach and duodenum the authors recommend to perform planned operations more often in elderly and senile patients, to combine suturing the ulcer with truncal vagotomy, intensive therapy, administration of drugs, catheterization of the superior mesenterial artery.

Adult↗
PubMed1989

[Neoplasms of the duodenum. A description of 2 clinical cases].

Duodenal tumours are a rare pathology, hard to diagnose early because of the unsubstantial symptomatology even though, in recent years, with the advent of improved techniques, a larger number have found their way into the literature. Two cases of duodenal cancer, one an adenocarcinoma localised in the first portion of the duodenum and one a subpapillary leiomyosarcoma are reported. 2 and 5 years respectively after the operation, both patients are in good health and do not present signs of disease.

Adenocarcinoma↗
PubMed1989

Villous adenoma of the duodenum. Case report.

Two rare cases of villous adenoma of the duodenum are described. Obstructive jaundice was the presenting clinical feature. Histologically the tumour was benign in both cases. Local excision was performed. One year later both patients were free from recurrence, but one was treated for gastric adenocarcinoma after 2 years. The literature is reviewed.

Adenoma↗
PubMedDate not supplied

[Echographic and x-ray computed tomographic aspects of intramural hematoma of the duodenum. Apropos of a case].

Radiologic imaging in a case of intramural hematoma of duodenum demonstrated typical appearances of the lesion. Ultrasound imaging of the duodenal hematoma was sufficiently characteristic to be used as a basis for a semeiologic discussion and to orientate diagnosis. The relevant literature is reviewed, and value and indications of different imaging techniques for diagnosis and follow up of the hematoma discussed.

Adult↗
PubMed1988

Von Recklinghausen neurofibromatosis with carcinoid tumor and submucous leiomyomas of the duodenum.

We report on a 63-year-old man with von Recklinghausen neurofibromatosis who developed a carcinoid tumor in the periampullary region and multiple small-sized leiomyomas in the duodenal wall. A high prevalence of gastrointestinal carcinoids has previously been recognized in patients with von Recklinghausen neurofibromatosis, the commonest site of origin being the duodenum or the periampullary region. The association of both conditions seems to be more than casual. Abnormalities in the development of the complex of von Campenhout or high circulating levels of nerve growth factor have been the mechanisms postulated to account for this association.

Carcinoma↗