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Surgical Laparoscopy, Endoscopy &... Dec 2019Congenital hernias are rare findings, and their diagnosis is often delayed due to an incorrect interpretation of the clinical symptoms and/or images. We present a rare... (Review)
Review
INTRODUCTION
Congenital hernias are rare findings, and their diagnosis is often delayed due to an incorrect interpretation of the clinical symptoms and/or images. We present a rare case of left-sided paraduodenal hernia at the ligament of Treitz, followed by a review of the literature.
CASE PRESENTATION
We report the case of a 20-year-old patient with unusual, recurring abdominal pain in the past 3 months. There were no previous operations or past illnesses in the patient's history. The computed tomographic scan showed a misplacement of small bowel into the lesser sack. With high suspicion of an internal hernia, we performed a diagnostic laparoscopy, which revealed a Treitz hernia. The reduction and fixation could be carried out fully with minimally invasive surgery with an uneventful postoperative course and complete recovery.
CONCLUSION
A Treitz hernia is a rare cause of unspecific abdominal pain and the clinical signs are difficult to interpret. However, its knowledge may help to avoid emergency procedures and provide quick recovery of the patients. We recommend the laparoscopic approach as the first choice of treatment in all cases of internal hernia in the absence of peritoneal irritation or severe bowel obstruction.
Topics: Duodenal Diseases; Duodenum; Hernia, Abdominal; Herniorrhaphy; Humans; Intestinal Obstruction; Laparoscopy; Male; Tomography, X-Ray Computed; Young Adult
PubMed: 31385923
DOI: 10.1097/SLE.0000000000000704 -
Digestive Diseases and Sciences Dec 2022
Topics: Humans; Gastric Bypass; Gastroenterostomy; Duodenal Diseases; Intestinal Fistula; Stomach
PubMed: 36136280
DOI: 10.1007/s10620-022-07694-3 -
The Journal of Small Animal Practice May 2018A one-year-old female cocker spaniel presented with a 6-month history of persistent diarrhoea. Abdominal ultrasonographic examination revealed mild diffuse thickening of...
A one-year-old female cocker spaniel presented with a 6-month history of persistent diarrhoea. Abdominal ultrasonographic examination revealed mild diffuse thickening of the intestinal wall coupled with mesenteric lymphadenopathy. A connection between the duodenum and the colon was observed during an endoscopic procedure and confirmed by computed tomography. Surgical resection of the communication allowed remission of the diarrhoea. Histology showed a normal duodenal epithelium and muscular layer. A duodenocolic fistula is an abnormal connection within the digestive tract, which in humans is usually considered a complication of a local pathological condition. Due to the absence of a predisposing cause and, in view of the dog's age and histological results, a congenital origin was suspected.
Topics: Animals; Colonic Diseases; Diarrhea; Dog Diseases; Dogs; Duodenal Diseases; Endoscopy, Gastrointestinal; Female; Intestinal Fistula; Tomography, X-Ray Computed
PubMed: 28369893
DOI: 10.1111/jsap.12677 -
Il Giornale Di Chirurgia 2018Bleedings such as melaena are related to diseases in the upper gastrointestinal tract. In 0.06% - 5% of cases these incidents are due to the presence of diverticula of...
BACKGROUND
Bleedings such as melaena are related to diseases in the upper gastrointestinal tract. In 0.06% - 5% of cases these incidents are due to the presence of diverticula of the small intestine, which are asymptomatic and unrecognized in most patients and are only fully diagnosed in cases when complications occur.
CASE REPORT
An 88-year old male patient presented with severe anaemia, asthenia and melaena in the previous days. An esophagogastroduodenoscopy (EGDS) was performed with evidence of stenosis in the second part of the duodenum and a blood clot in the posterior wall without signs of active bleeding. A complete CT scan was carried out of the thorax, abdomen and pelvis using a contrast medium, which revealed a dilation of the stomach and of the first part of the duodenum with a diverticulum of the second. On the fourth day following admission the patient suffered a haemorrhagic shock and underwent an emergency surgical procedure with a bleeding diverticulum on the posterior wall of the duodenum tightly adhering to the pancreas being found. Therefore an atypical duodenal-jejunal resection was performed using a gastrojejunal Roux-en-Y bypass and the closure of the duodenal stump.
CONCLUSION
Diverticulosis of the duodenum and small intestine is considered a rare disease. According to the literature, treatment should be conservative, and surgical options considered only in those very rare cases of complicated and life-threatening diverticulosis.
Topics: Aged, 80 and over; Anastomosis, Roux-en-Y; Anastomotic Leak; Constriction, Pathologic; Diverticulum; Duodenal Diseases; Endoscopy, Digestive System; Fatal Outcome; Gastrointestinal Hemorrhage; Humans; Intestine, Small; Jejunal Diseases; Male; Melena; Pleural Effusion; Shock, Hemorrhagic; Surgical Wound Dehiscence
PubMed: 30563606
DOI: No ID Found -
Colorectal Disease : the Official... Nov 2020
Topics: Crohn Disease; Duodenal Diseases; Duodenum; Humans; Jejunum
PubMed: 32558111
DOI: 10.1111/codi.15202 -
Gastroenterology Clinics of North... Dec 2014Acute upper gastrointestinal bleeding (UGIB) is a common gastroenterological emergency. A vast majority of these bleeds have nonvariceal causes, in particular... (Review)
Review
Acute upper gastrointestinal bleeding (UGIB) is a common gastroenterological emergency. A vast majority of these bleeds have nonvariceal causes, in particular gastroduodenal peptic ulcers. Nonsteroidal antiinflammatory drugs, low-dose aspirin use, and Helicobacter pylori infection are the main risk factors for UGIB. Current epidemiologic data suggest that patients most affected are older with medical comorbidit. Widespread use of potentially gastroerosive medications underscores the importance of adopting gastroprotective pharamacologic strategies. Endoscopy is the mainstay for diagnosis and treatment of acute UGIB. It should be performed within 24 hours of presentation by skilled operators in adequately equipped settings, using a multidisciplinary team approach.
Topics: Acute Disease; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Duodenal Diseases; Endoscopy, Gastrointestinal; Esophageal Diseases; Gastrointestinal Hemorrhage; Helicobacter Infections; Helicobacter pylori; Humans; Incidence; Platelet Aggregation Inhibitors; Risk Factors; Stomach Diseases; Time Factors
PubMed: 25440917
DOI: 10.1016/j.gtc.2014.08.001 -
Canadian Journal of Gastroenterology &... 2018Portal hypertension is a serious complication of liver cirrhosis.
BACKGROUND
Portal hypertension is a serious complication of liver cirrhosis.
OBJECTIVE
To identify relevant endoscopic findings in patients with advanced cirrhosis and consecutive portal hypertension.
METHODS
This was a retrospective study of liver transplant candidates who underwent upper gastrointestinal endoscopy between April 2011 and November 2015.
RESULTS
A total of 1,045 upper endoscopies were analyzed. Portal hypertensive gastric and duodenal polyps were frequently observed and were associated with thrombocytopenia (p = 0.040; OR: 2.4, 95% CI 1.04-5.50), Child-Pugh score > 6 (p = 0.033; OR: 2.3, 95% CI 1.07-4.92), Model for End Stage Liver Disease score > 16 (p = 0.030; OR: 4.1, 95% CI 1.14-15.00), and previous rubber band ligation (p < 0.001; OR = 5.2, 95% CI 2.5-10.7). These polyps often recurred after polypectomy; however, no malignant transformation occurred during the observational time until October 2017. The most common endoscopic finding was esophageal varices, observed in more than 90% of patients.
CONCLUSION
Portal hypertensive polyposis is common in patients with advanced cirrhosis. Our data suggest that these polyps have benign characteristics.
Topics: Adult; Aged; Aged, 80 and over; Duodenal Diseases; Endoscopy, Gastrointestinal; Esophageal and Gastric Varices; Female; Humans; Hypertension, Portal; Intestinal Polyps; Liver Cirrhosis; Male; Middle Aged; Recurrence; Retrospective Studies; Stomach Diseases; Thrombocytopenia; Young Adult
PubMed: 30155451
DOI: 10.1155/2018/2182784 -
Journal of Digestive Diseases Apr 2019
Topics: Aged, 80 and over; Duodenal Diseases; Female; Gallstones; Gastric Outlet Obstruction; Humans
PubMed: 30756478
DOI: 10.1111/1751-2980.12713 -
Acta Gastroenterologica Latinoamericana Sep 2015In this case we present a patient with chronic abdominal pain of a year of evolution, three months before being admitted to hospital the patient presented melaena and...
In this case we present a patient with chronic abdominal pain of a year of evolution, three months before being admitted to hospital the patient presented melaena and anaemia. Within the surgery antecedents it appears a caesarean 2 years before and a cholecystectomy a year before. In the endoscopy study a textiloma was observed coming up from the posterosior side of the antrum which, after its endoscopic removal, showed a gastro-duodenal fistula with a non-patent pylorus.
Topics: Adult; Duodenal Diseases; Endoscopy, Gastrointestinal; Female; Foreign Bodies; Gastric Fistula; Humans; Stomach
PubMed: 28590605
DOI: No ID Found -
Medicine Dec 2014The giardiasis is a neglected parasitic disease. The WHO has estimated more than 280 million of human infections each year; however, intraepithelial giardiasis is a rare... (Review)
Review
The giardiasis is a neglected parasitic disease. The WHO has estimated more than 280 million of human infections each year; however, intraepithelial giardiasis is a rare entity, there are only 5 reports showing invasive giardiasis. A pediatric female patient with chronic abdominal pain, diarrhea, or pasty stools, without fever, was seen in the Gastroenterology and Nutrition Service. The stool studies were negative for pathogens and lactose hydrogen breath test was positive. The presumptive clinical diagnosis was giardiasis and the patient was empirically treated with nitazoxanide. But, the patient persisted with abdominal pain and pasty stools. Endoscopy was indicated to search for Helicobacter and Giardia. Guardian and patient gave written informed consent. Hematological profile was normal. The endoscopy was performed under general anesthesia and the biopsies and duodenal aspirate were obtained. The microscopic analyses of duodenal fluid showed Giardia trophozoites. Electron microscopic analysis was negative for Helicobacter pylori, but Giardia trophozoites with a typical crescent shape within the tissue were found. The patient was treated with tinidazole, subsequent tests showed that lactose absorption was normal, stool examinations were negative for Giardia and abdominal pain had stopped. This case suggest that intraepithelial giardiasis could be a common entity but unseen because the giardiasis diagnosis is usually made on fecal samples. Future studies are necessary to determine the role of intraepithelial trophozoites in giardiasis pathogenic mechanisms.
Topics: Child; Duodenal Diseases; Endoscopy, Gastrointestinal; Female; Giardiasis; Humans; Intestinal Mucosa; Microscopy, Electron
PubMed: 25546671
DOI: 10.1097/MD.0000000000000277