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Radiologic Clinics of North America Jul 2015Pancreatic and duodenal injuries are rare but life-threatening occurrences, often occurring in association with other solid organ injuries. Findings of pancreatic and... (Review)
Review
Pancreatic and duodenal injuries are rare but life-threatening occurrences, often occurring in association with other solid organ injuries. Findings of pancreatic and duodenal trauma on computed tomography and MR imaging are often nonspecific, and high levels of clinical suspicion and understanding of mechanism of injury are imperative. Familiarity with the grading schemes of pancreatic and duodenal injury is important because they help in assessing for key imaging findings that directly influence management. This article presents an overview of imaging of blunt and penetrating pancreatic and duodenal injuries, including pathophysiology, available imaging techniques, and variety of imaging features.
Topics: Abdominal Injuries; Diagnosis, Differential; Duodenum; Humans; Pancreas; Radiography, Abdominal; Tomography, X-Ray Computed
PubMed: 26046509
DOI: 10.1016/j.rcl.2015.02.009 -
Obesity Surgery Dec 2018The majority of bariatric surgical stapling procedure concepts were developed prior to the understanding of obesity as an energy storage disease. Conventional treatments... (Review)
Review
The majority of bariatric surgical stapling procedure concepts were developed prior to the understanding of obesity as an energy storage disease. Conventional treatments did not consider the impact of macronutrients on hormones and glucose variability. Current recommendations suggest diets low in glycemic load, with moderate protein and unsaturated fat. Roux-en-Y gastric bypass promotes glucose variability which can be harmful for health and encourage weight regain. Classic duodenal switch with short common channels may prevent absorption of measurable fat-soluble vitamins and frequently untested essential fatty acids. The purpose of this review is to discuss these factors and explain why single anastomosis duodenal switch reduces glucose variability, allows for absorption of critical fats and fat-soluble vitamins, and has potential to offer better weight loss and metabolic outcomes.
Topics: Anastomosis, Surgical; Bariatric Surgery; Biomarkers; Duodenum; Glucose; Humans; Nutritional Physiological Phenomena; Obesity, Morbid; Stomach; Weight Loss
PubMed: 30288670
DOI: 10.1007/s11695-018-3535-y -
Infection Oct 2022Duodenal involvement in COVID-19 is poorly studied. Aim was to describe clinical and histopathological characteristics of critically ill COVID-19 patients suffering from...
PURPOSE
Duodenal involvement in COVID-19 is poorly studied. Aim was to describe clinical and histopathological characteristics of critically ill COVID-19 patients suffering from severe duodenitis that causes a significant bleeding and/or gastrointestinal dysmotility.
METHODS
In 51 critically ill patients suffering from SARS-CoV-2 pneumonia, severe upper intestinal bleeding and/or gastric feeding intolerance were indications for upper gastrointestinal endoscopy. Duodenitis was diagnosed according to macroscopic signs and mucosal biopsies. Immunohistochemistry was performed to detect viral specific protein and ACE2. In situ hybridization was applied to confirm viral replication.
RESULTS
Nine of 51 critically ill patients (18%) suffering from SARS-CoV-2 pneumonia had developed upper GI bleeding complications and/or high gastric reflux. Five of them presented with minor and four (44%) with severe duodenitis. In two patients, erosions had caused severe gastrointestinal bleeding requiring PRBC transfusions. Immunohistochemical staining for SARS-CoV-2 spike protein was positive inside duodenal enterocytes in three of four patients suffering from severe duodenitis. Viral replication could be confirmed by in situ hybridization.
CONCLUSION
Our data suggest that about 8% of critically ill COVID-19 patients may develop a severe duodenitis presumably associated with a direct infection of the duodenal enterocytes by SARS-CoV-2. Clinical consequences from severe bleeding and/or upper gastrointestinal dysmotility seem to be underestimated.
Topics: Angiotensin-Converting Enzyme 2; COVID-19; Critical Illness; Duodenitis; Humans; Infant, Newborn; SARS-CoV-2; Spike Glycoprotein, Coronavirus; Tropism
PubMed: 35182354
DOI: 10.1007/s15010-022-01769-z -
Digestive Endoscopy : Official Journal... Mar 2022
Topics: Duodenal Neoplasms; Duodenum; Humans; Neoplasms, Glandular and Epithelial
PubMed: 35178788
DOI: 10.1111/den.14254 -
Georgian Medical News Mar 2022Recurrent abdominal pain (RAP) and dyspepsia are common complaints in children. These symptoms are often associated with Helicobacter pylori (Hp) infection. The aim of...
Recurrent abdominal pain (RAP) and dyspepsia are common complaints in children. These symptoms are often associated with Helicobacter pylori (Hp) infection. The aim of the present study was to prospectively analyze clinical, endoscopic, and histological characteristics of Hp+ and Hp- children with RAP and/or dyspepsia. Patients aged 2-18 years with RAP and/or dyspepsia, referred for an upper endoscopy to Arabkir Medical Center - Institute of Child and Adolescent Health (Arabkir MC-ICAH) from November 2015 to December 2017, were involved in the study. Histology was assessed according to the updated Sydney system. Gastric and duodenal specimens were stained by modified Giemsa staining for Hp infection. One antral biopsy was cultured in Hp selective media. 150 patients were included into the study: 70.7% Hp+, 29.3% Hp-. Nausea and vomiting were significantly more common in Hp+ patients (p<0.05). Gastric nodularity (p=0.02), erosions in the stomach (p=0.056), and duodenal erosions (p=0.019) were more common in Hp+. Chronic active (p=0.027) and non-active gastritis (p=0.002), cumulative findings of metaplasia/dysplasia/atrophy in the stomach (p=0.014) and chronic non-active duodenitis (p=0.016), were significantly more common in Hp+ patients. Hp infection prevalence is high in Armenian children with dyspepsia and/or RAP. Clinical symptoms, endoscopic findings, and histopathological findings were significantly different in Hp+ patients as compared to Hp- patients.
Topics: Abdominal Pain; Adolescent; Armenia; Child; Duodenitis; Dyspepsia; Gastric Mucosa; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans
PubMed: 35417865
DOI: No ID Found -
Journal of Pediatric Gastroenterology... Oct 2023We describe a cohort of 33 patients with eosinophilic esophagitis (EoE) and incidental duodenal bulb inflammation, termed bulbar duodenitis (BD). We conducted a...
We describe a cohort of 33 patients with eosinophilic esophagitis (EoE) and incidental duodenal bulb inflammation, termed bulbar duodenitis (BD). We conducted a single-center retrospective cohort study and recorded demographics, clinical presentation, endoscopic, and histological findings. BD was observed at the initial endoscopy in 12 cases (36%) and at a subsequent endoscopy in the remainder. Bulbar histology was usually a mix of chronic and eosinophilic inflammation. Patients were more likely to have active EoE (n = 31, 96.9%) at time of BD diagnosis. Our data indicate that the duodenal bulb of children with EoE should be carefully examined at each endoscopy and mucosal biopsies considered. Larger studies are needed to explore this association.
Topics: Humans; Child; Eosinophilic Esophagitis; Duodenitis; Retrospective Studies; Inflammation; Endoscopy, Gastrointestinal
PubMed: 37098053
DOI: 10.1097/MPG.0000000000003812 -
BMC Nephrology Mar 2023The coinfection between cytomegalovirus (CMV) and either human herpesvirus-6 (HHV-6) or HHV-7 in renal transplant recipients is well known; however, there have been few...
BACKGROUND
The coinfection between cytomegalovirus (CMV) and either human herpesvirus-6 (HHV-6) or HHV-7 in renal transplant recipients is well known; however, there have been few reports of coinfection of CMV associated with HHV-8. This paper presents a first case of acute gastric ulcer and duodenitis associated with CMV and HHV-8 coinfection after renal transplantation.
CASE PRESENTATION
A 33-year-old male with a history of kidney transplantation was admitted to hospital because of postural epigastric pain. The recipient was CMV seropositive prior to transplantation and received trimethoprim-sulfamethoxazole without universal prophylaxis. Approximately 5 months after renal transplant, the recipient complained postural epigastric pain. An endoscopy revealed diffuse ulcerative lesions in the lower body and in the antrum of the stomach, as well as several erythematous mucosal lesions in the duodenum. Histopathologic examination identified CMV inclusions consistent with invasive CMV disease and immunohistochemical staining showed positive results for HHV-8 and CMV. No tumorous diseases such as Kaposi's sarcoma were detected. After 3 weeks of intravenous ganciclovir treatment, we observed that serum CMV PCR remained within the normal range and clinical symptoms improved. A follow-up endoscopy performed 3 weeks later showed that the severity of the above mentioned lesions had improved.
CONCLUSIONS
We report the first case of a renal transplant recipient diagnosed with acute gastric ulcer and duodenitis associated with coinfection of CMV and HHV-8. Ganciclovir appears to be effective in diseases associated with coinfection of CMV and HHV-8.
Topics: Male; Humans; Adult; Cytomegalovirus; Kidney Transplantation; Herpesvirus 8, Human; Stomach Ulcer; Duodenitis; Coinfection; Cytomegalovirus Infections; Ganciclovir; Pain; Antiviral Agents
PubMed: 36964509
DOI: 10.1186/s12882-023-03127-z -
Digestive Endoscopy : Official Journal... Jan 2023
Topics: Humans; Stents; Metals; Duodenum; Treatment Outcome
PubMed: 36289061
DOI: 10.1111/den.14451 -
Revista de Gastroenterologia de Mexico... 2020
Topics: Duodenum; Female; Humans; Intestinal Perforation; Middle Aged; Stents
PubMed: 32336593
DOI: 10.1016/j.rgmx.2020.01.005 -
Phlebology Sep 2018Objectives Duodenal perforation by an inferior vena cava filter is rare and life threatening. Our objective is to find out number of occurrences and compare diagnosis... (Review)
Review
Objectives Duodenal perforation by an inferior vena cava filter is rare and life threatening. Our objective is to find out number of occurrences and compare diagnosis and treatments. Method The reference list of Malgor's review in 2012 was considered as well as all new articles with eligible features. Search was conducted on specific databases: MEDLINE, Web of Sciences, and Literatura Latino-Americana e do Caribe em Ciências da Saúde. Results Most of the patients presented with upper abdominal pain and the use of radiologic studies was crucial for diagnosis. The most common treatment was laparotomy with filter or strut removal plus duodenum repair. However, clinical conditions of patients must be considered and the endovascular technique with endograft deployment into inferior vena cava may be an alternative. Conclusion Duodenal perforation by an inferior vena cava filter is uncommon and in high-risk surgical patients endovascular repair must be considered.
Topics: Duodenum; Humans; Intestinal Perforation; Vena Cava Filters
PubMed: 28931347
DOI: 10.1177/0268355517731049