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Diagnostic and Interventional Imaging Oct 2017Recent advances in imaging have resulted in marked changes in the investigation of the duodenum, which still remains primarily evaluated with videoendoscopy. However,... (Review)
Review
Recent advances in imaging have resulted in marked changes in the investigation of the duodenum, which still remains primarily evaluated with videoendoscopy. However, improvements in computed tomography (CT) and magnetic resonance (MR) imaging have made detection and characterization of duodenal mass-forming abnormalities easier. The goal of this pictorial review was to illustrate the most common conditions of the duodenum that present as mass-forming lesions with a specific emphasis on CT and MR imaging. MR imaging used in conjunction with duodenal distension appears as a second line imaging modality for the characterization of duodenal mass-forming lesions. CT remains the first line imaging modality for the detection and characterization of a wide range of duodenal mass-forming lesions.
Topics: Adenocarcinoma; Adenoma; Arteriovenous Malformations; Brunner Glands; Choristoma; Diverticulum; Duodenal Diseases; Duodenum; Gastrointestinal Stromal Tumors; Hamartoma; Hemangioma; Humans; Hyperplasia; Intestinal Polyposis; Leiomyoma; Lipoma; Lymphoma; Magnetic Resonance Imaging; Neuroendocrine Tumors; Pancreas; Tomography, X-Ray Computed; Tuberculosis, Gastrointestinal
PubMed: 28185840
DOI: 10.1016/j.diii.2017.01.004 -
Digestive Endoscopy : Official Journal... Jul 2023In recent years, there have been significant advances in the endoscopic resection (ER) procedures of superficial nonampullary duodenal epithelial tumors (SNADETs). A... (Review)
Review
In recent years, there have been significant advances in the endoscopic resection (ER) procedures of superficial nonampullary duodenal epithelial tumors (SNADETs). A preoperative endoscopic diagnosis is thus deemed necessary in determining the indication for subsequent ER. For the histologic and endoscopic diagnosis of SNADETs, understanding the mucin phenotype is inevitable. Recently, two diagnostic algorithms for the differential diagnosis of SNADETs from nonneoplastic lesions under magnifying endoscopy with narrow-band imaging have been proposed. In addition, various endoscopic approaches have been proposed to differentiate low- and high-grade adenomas/carcinomas, including white light endoscopy, magnifying image-enhanced endoscopy, and endocytoscopy. These methods, however, have not been standardized with respect to the classification of their findings and the validation of their diagnostic accuracy. Moreover, there are still concerns with respect to the histologic criteria required to establish a SNADETs diagnosis. Standardization in the histologic and endoscopic diagnosis of SNADETs is needed.
Topics: Humans; Duodenoscopy; Adenocarcinoma; Duodenum; Duodenal Neoplasms; Carcinoma
PubMed: 36626023
DOI: 10.1111/den.14514 -
The American Surgeon Nov 2016The surgical management of duodenal pathology is challenging because of its retroperitoneal position and shared blood supply with the pancreas. We present three types of... (Review)
Review
The surgical management of duodenal pathology is challenging because of its retroperitoneal position and shared blood supply with the pancreas. We present three types of limited resection of the duodenum for the removal of superficial or small nonampullary duodenal (NADL) lesions, and also a review of the English literature regarding management, such as endoscopic resection and limited duodenal resection. Ten cases underwent limited resections of the duodenum for superficial or small NADL lesions from 2011 to 2015. Pancreas-preserving segmental duodenectomy was performed in three cases, local full-thickness resection was performed in three and transduodenal submucosal dissection was performed in four. One patient experienced pancreatic fistula as a postoperative complication. Postoperative pathological diagnosis were adenoma (n = 2), mucosal adenocarcinomas (n = 5), and neuroendocrine tumor (n = 3). Surgical margin was negative in all cases, and no patient has experienced postoperative recurrence or metastasis. Limited resections of the duodenum were feasible and safe procedures for patients with superficial or small NADL lesions. Laparoscopic surgery may be considered in treatment for these tumors. However, the optimal surgical management for superficial or small nonampullary duodenal lesions remains controversial.
Topics: Adenocarcinoma; Adenoma; Adult; Aged; Aged, 80 and over; Carcinoma, Neuroendocrine; Dissection; Duodenal Neoplasms; Duodenum; Female; Humans; Male; Medical Illustration; Middle Aged; Pancreatic Fistula; Pancreaticoduodenectomy; Postoperative Complications
PubMed: 28206943
DOI: No ID Found -
BMC Gastroenterology May 2022Primary duodenal cancer (PDC) is rare, especially signet-ring cell carcinoma (SRCC) of the duodenal bulb, and it is commonly misdiagnosed as an ulceration. Here, we... (Review)
Review
BACKGROUND
Primary duodenal cancer (PDC) is rare, especially signet-ring cell carcinoma (SRCC) of the duodenal bulb, and it is commonly misdiagnosed as an ulceration. Here, we report a rare case of SRCC of the duodenal bulb presenting with gastrointestinal hemorrhage in an 82-year-old man.
CASE PRESENTATION
An 82-year-old man was admitted for gastrointestinal hemorrhage. Physical examination revealed upper abdominal tenderness and pale appearance, but was otherwise unrevealing. Laboratory workup was significant for anemia. Imaging showed no abnormalities. Two endoscopic evaluations along with interventional embolization were attempted and, unfortunately, adequate hemostasis was not achieved, resulting in distal subtotal gastrectomy, including the duodenal bulb. SRCC of the duodenal bulb was diagnosed based on pathology after surgery. Post-operatively, the patient experienced persistent gastrointestinal bleeding. Family declined further intervention and the patient eventually died one month post-resection.
CONCLUSIONS
SRCC in the duodenal bulb is difficult to diagnose. For those with high-risk factors, endoscopic examination and biopsy are recommended. For patients who can receive radical tumor resection, pancreaticoduodenectomy (PD) is considered a first-line option. Early diagnosis and resection have been shown to improve prognosis.
Topics: Aged, 80 and over; Carcinoma, Signet Ring Cell; Duodenum; Embolization, Therapeutic; Endoscopy; Gastrointestinal Hemorrhage; Humans; Male
PubMed: 35534806
DOI: 10.1186/s12876-022-02267-0 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The given paper describes a case of treating adenocarcinoma of the papilla of Vater diagnosed as the cause after an episode of acute pancreatitis. The etiology of aсute...
The given paper describes a case of treating adenocarcinoma of the papilla of Vater diagnosed as the cause after an episode of acute pancreatitis. The etiology of aсute pancreatitis was considered idiopathic until the onset of complaints caused by tumor growth. The volume of radical surgery has changed intraoperatively due to the detection of infected limited necrotic clusters, didn't diagnosed both laboratory and instrumentally. Pathomorphological conclusion: considering clinical data, low-grade (G3) adenocarcinoma of the major duodenal papilla, which developed from pre-existing tubular villous adenoma of the duodenum or intraampullary papillary neoplasia (IAPN). Predicting the early detection of MNPs after AP episode requires further research by improving imaging techniques, introducing new non-invasive techniques and investigating circulating biomarkers. The scope of surgery for patients with clinically significant complications of tumor growth and identified competing diagnosis at the target site should be individually decided and weighed. Infected pancreatitis in the late stages requires careful diagnosis.
Topics: Acute Disease; Adenocarcinoma; Ampulla of Vater; Humans; Pancreatitis, Acute Necrotizing
PubMed: 35633340
DOI: 10.36740/WLek202204222 -
Obesity Research & Clinical Practice 2022The effects of bariatric surgery on the development of gastrointestinal cancers remain ill defined. We present a case of jejunal adenocarcinoma developing 19 years after...
The effects of bariatric surgery on the development of gastrointestinal cancers remain ill defined. We present a case of jejunal adenocarcinoma developing 19 years after biliopancreatic diversion (BPD) procedure according to Scopinaro's technique. The patient developed a marked distension of the biliopancreatic limb caused by a jejunal mass, evolving towards the so called "duodenal blowout". Emergency jejunal resection of the biliopancreatic limb, with creation of a new end-to-side jejunal-ileal anastomosis was necessary. The histological examination resulted in a moderately-differentiated ulcerated adenocarcinoma, with reactive lymph nodes and tumor-free resection margins. Tumors of the gastrointestinal system can arise following malabsorptive operations for morbid obesity, and they may be difficult to diagnose, since the symptoms are often attributed to the anatomical-functional changes resulting from this type of surgery. The case reported herein suggests that there is a need for surveillance in patients complaining of digestive symptoms after malabsorptive bariatric surgery.
Topics: Adenocarcinoma; Anastomosis, Surgical; Biliopancreatic Diversion; Duodenum; Humans; Obesity, Morbid
PubMed: 35562313
DOI: 10.1016/j.orcp.2022.05.002 -
The American Journal of Gastroenterology Nov 2017
Topics: Adenocarcinoma; Adenoma; Aged; Cytodiagnosis; Duodenal Neoplasms; Duodenoscopy; Duodenum; Endoscopic Mucosal Resection; Female; Humans; Male; Middle Aged
PubMed: 29109501
DOI: 10.1038/ajg.2017.276 -
Polski Przeglad Chirurgiczny Feb 2015Duodenal carcinoma is a rare tumor of the gastrointestinal tract of an insidious and secretive course, often diagnosed during the advanced stage of the disease. The...
Duodenal carcinoma is a rare tumor of the gastrointestinal tract of an insidious and secretive course, often diagnosed during the advanced stage of the disease. The study presented a case of a female patient diagnosed with duodenal carcinoma, subjected to two-staged surgery. The initial surgical intervention consisted in the implementation of a gastrointestinal anastomosis, followed by radical surgery by means of Whipple's method performed after three years.
Topics: Adenocarcinoma; Anastomosis, Surgical; Duodenal Diseases; Duodenal Neoplasms; Duodenum; Female; Humans; Intestinal Fistula; Middle Aged; Treatment Outcome
PubMed: 25720113
DOI: 10.2478/pjs-2014-0096 -
Surgical Oncology Sep 2022Most tumours in the head of the pancreas are adenocarcinomas of the exocrine pancreas. However, carcinomas located in the head of the pancreas may originate from the... (Review)
Review
Most tumours in the head of the pancreas are adenocarcinomas of the exocrine pancreas. However, carcinomas located in the head of the pancreas may originate from the papilla of Vater, the distal part of the common bile duct, or the duodenum. Tumours of that region, within 2 cm of the greater duodenal papilla, have been usually described as periampullary neoplasms. Adenocarcinomas separated from the major duodenal papilla and located in the major pancreatic duct, common bile duct, or duodenum are identified as ductal pancreatic carcinomas, distal bile duct cholangiocarcinomas or duodenal carcinomas. Surgical treatment is the only chance for cure. Pancreatoduodenectomy is the procedure of choice. Regional lymphadenectomy and removal of at least 16 lymph nodes are necessary for optimal long-term outcomes. Indications for adjuvant chemotherapy remain controversial. This review evaluates the available data on the pathological assessment of periampullary tumours and discusses the controversies of therapeutic management, emphasising adjuvant treatment.
Topics: Adenocarcinoma; Ampulla of Vater; Carcinoma, Pancreatic Ductal; Common Bile Duct Neoplasms; Humans; Pancreatic Neoplasms
PubMed: 36152420
DOI: 10.1016/j.suronc.2022.101853 -
Southern Medical Journal Apr 2009While colorectal cancer is one of the most commonly encountered gastrointestinal malignancies, primary lymphoma is an uncommon neoplasm of the gastrointestinal tract....
While colorectal cancer is one of the most commonly encountered gastrointestinal malignancies, primary lymphoma is an uncommon neoplasm of the gastrointestinal tract. The duodenum is not a common location for the recurrence of colon cancer or of primary gastrointestinal lymphoma. Studies regarding mantle cell lymphoma (MCL) as a secondary synchronous or metachronous malignancy are limited. Here we report a patient who received concurrent chemoradiotherapy for his advanced sigmoid adenocarcinoma and developed MCL in the duodenal bulb 20 months later. Suspected lesions should be biopsied and examined for a secondary neoplasm, especially when they appear in an uncommon location for metastasis or direct invasion.
Topics: Adenocarcinoma; Aged; Colon, Sigmoid; Colonic Neoplasms; Contrast Media; Diagnosis, Differential; Duodenum; Fatal Outcome; Humans; Lymphoma, Mantle-Cell; Male; Tomography, X-Ray Computed
PubMed: 19279526
DOI: 10.1097/SMJ.0b013e31819bc4b0