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Seminars in Pediatric Surgery Feb 2022Congenital duodenal obstruction (CDO) occurs due to intrinsic and extrinsic mechanisms but is most often caused by intrinsic duodenal atresia and stenosis. This review... (Review)
Review
Congenital duodenal obstruction (CDO) occurs due to intrinsic and extrinsic mechanisms but is most often caused by intrinsic duodenal atresia and stenosis. This review will summarize the history, epidemiology, and etiologies associated with the most common causes of CDO. The clinical presentation, complex diagnostic considerations, and current surgical repair options for duodenal atresia and stenosis will also be discussed. Finally, both historical and recent controversies which continue to affect the surgical decision-making in the management of these patients will be highlighted.
Topics: Duodenal Obstruction; Humans; Intestinal Atresia
PubMed: 35305801
DOI: 10.1016/j.sempedsurg.2022.151140 -
Pediatric Radiology Jul 2016Bilious emesis is a common cause for evaluation in pediatric radiology departments. There are several causes of congenital duodenal obstruction, most of which require... (Review)
Review
Bilious emesis is a common cause for evaluation in pediatric radiology departments. There are several causes of congenital duodenal obstruction, most of which require elective surgical correction, but the potential of malrotation with midgut volvulus demands prompt imaging evaluation. We review the various causes of congenital duodenal obstruction with an emphasis on the approach to imaging evaluation and diagnosis.
Topics: Child; Constriction, Pathologic; Diagnostic Imaging; Duodenal Obstruction; Humans; Intestinal Volvulus
PubMed: 27324508
DOI: 10.1007/s00247-016-3603-1 -
Journal of Medical Case Reports Aug 2020Artificial dentures are the most common object ingested by elderly patients and account for 4-18% of all foreign body ingestions. Denture impaction in the small bowel is... (Review)
Review
BACKGROUND
Artificial dentures are the most common object ingested by elderly patients and account for 4-18% of all foreign body ingestions. Denture impaction in the small bowel is a rare phenomenon. Surgery of the duodenum is difficult, so endoscopy should be the first choice in these patients. There are very rare case reports on denture ingestion-induced duodenal obstruction or perforation, so the aim of this publication was to show a rare case of accidental ingestion of a dental prosthesis with duodenal obstruction and also perforation that could not be treated with endoscopic management and was managed with duodenal kocherization and gastrostomy.
CASE PRESENTATION
A 47-year-old Iranian woman presented to our hospital with epigastric abdominal pain of 2 hours' duration after the accidental ingestion of a dental prosthesis 2 days before admission. The patient had severe epigastric tenderness. Radiographic examination revealed nothing. Upper gastrointestinal endoscopy showed a swallowed lodged denture in the second to third parts of the duodenum, and the attempt to extract the denture failed. The patient underwent laparotomy and duodenal kocherization, pushing the denture to the stomach, and gastrostomy, and the denture was brought out without any complications.
CONCLUSIONS
Patients with old and worn dentures should have their prosthesis reconstructed and redesigned periodically in order to prevent denture ingestion and its complications. Early surgical intervention is recommended in patients with failed endoscopic extraction of foreign bodies and in those with duodenal perforation.
Topics: Aged; Deglutition; Dental Prosthesis; Duodenal Obstruction; Female; Foreign Bodies; Humans; Iran; Middle Aged
PubMed: 32799932
DOI: 10.1186/s13256-020-02456-z -
Texas Heart Institute Journal Nov 2022
Topics: Humans; Duodenal Obstruction; Aortic Aneurysm, Abdominal
PubMed: 36450143
DOI: 10.14503/THIJ-21-7668 -
Journal of Gastrointestinal Surgery :... Apr 2021
Topics: Duodenal Obstruction; Humans; Intestinal Obstruction; Lipoma; Pancreas
PubMed: 32779086
DOI: 10.1007/s11605-020-04773-6 -
Journal of Pediatric Surgery Oct 1989In a series of 34 infants with congenital duodenal obstruction, 15 were diagnosed by antenatal ultrasound between the fifth month of gestation and term. Fourteen... (Review)
Review
In a series of 34 infants with congenital duodenal obstruction, 15 were diagnosed by antenatal ultrasound between the fifth month of gestation and term. Fourteen patients were available for follow-up. In 10 of 14 cases, patients were available for follow-up. In 10 of 14 cases, parents were informed of the diagnosis antenatally and, in 9, were advised of the possibility of surgery in the neonatal period. Parents felt the information helped them prepare for the surgical and medical interventions necessary in the postnatal management of their infants. The mean birth weight and gestational age of these infants were comparable with those diagnosed postnatally. Associated congenital anomalies were more common in the patients with a postnatal diagnosis. In the total group of 34 infants with duodenal obstruction, 32 had surgical repair with a survival rate of 94%. Surgical procedures were comparable between the two groups. Surgical intervention occurred earlier in the neonatal period when an antenatal diagnosis was made. Overall survival in the entire series was 88% with four deaths attributed to severe associated congenital anomalies. We conclude that (1) the antenatal diagnosis of duodenal obstruction influences parents positively in coping with the anomaly, and (2) although surgery was performed sooner, the outcome of infants with duodenal obstruction was not changed by providing an antenatal diagnosis.
Topics: Duodenal Obstruction; Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Pregnancy; Prenatal Diagnosis; Ultrasonography
PubMed: 2681653
DOI: 10.1016/s0022-3468(89)80208-8 -
British Journal of Hospital Medicine Feb 1989The intestinal obstruction of duodenal atresia needs urgent differential diagnosis from malrotation with its risk of midgut volvulus and gangrene. There is an uncommon... (Review)
Review
The intestinal obstruction of duodenal atresia needs urgent differential diagnosis from malrotation with its risk of midgut volvulus and gangrene. There is an uncommon variant with a high incidence of familial recurrence, and a significant association with Down's syndrome, although the majority of the babies are otherwise normal. Oblique end-to-end anastomosis around the atresia is the preferred treatment and has a high success rate.
Topics: Anastomosis, Surgical; Diagnosis, Differential; Duodenal Obstruction; Duodenum; Humans; Infant, Newborn; Intestinal Atresia; Postoperative Care; Recurrence
PubMed: 2653530
DOI: No ID Found -
Annals of the Royal College of Surgeons... Oct 2020Idiopathic retroperitoneal haematoma is a rare clinical entity; resulting duodenal obstruction is even more occult. It can pose a diagnostic challenge due to variable... (Review)
Review
Idiopathic retroperitoneal haematoma is a rare clinical entity; resulting duodenal obstruction is even more occult. It can pose a diagnostic challenge due to variable presentations. Timely management requires a high index of suspicion and a multidisciplinary approach. Surgery is indicated in patients refractory to conservative treatment and failure of endoscopic or interventional radiology options. We report an interesting case illustrating the rarity and severity of this condition, with a review of the literature.
Topics: Duodenal Obstruction; Hematoma; Humans; Male; Middle Aged; Retroperitoneal Space
PubMed: 32538127
DOI: 10.1308/rcsann.2020.0117 -
Inflammatory Bowel Diseases Feb 2018Symptomatic duodenal Crohn's disease (CD) is an uncommon disease presentation, especially in isolation. The most common duodenal disease phenotype is stricturing disease... (Review)
Review
Symptomatic duodenal Crohn's disease (CD) is an uncommon disease presentation, especially in isolation. The most common duodenal disease phenotype is stricturing disease rather than inflammatory or perforating. Most patients are asymptomatic and are therefore diagnosed incidentally by cross-sectional imaging or endoscopy. Medical management includes proton pump inhibitor therapy and immunosuppressive therapy including corticosteroids, immunomodulatory therapy, and biologic therapy. Symptomatic strictures can often be treated medically or endoscopically, and do not always require surgery. Surgical options include resection with primary anastomosis, bypass with a gastrojejunostomy, and strictureplasty. Treatment recommendations are largely based on limited evidence from small series and expert opinion. Therefore, the optimal treatment algorithm remains largely subjective and undefined.
Topics: Crohn Disease; Duodenal Obstruction; Endoscopy, Digestive System; Humans; Prognosis; Randomized Controlled Trials as Topic; Recurrence; Reoperation
PubMed: 29462397
DOI: 10.1093/ibd/izx083 -
African Journal of Paediatric Surgery :... 2022Pre-duodenal portal vein (PDPV) is a rare anomaly and a rare cause of duodenal obstruction (DO), with only a few cases reported in the literature. We present an infant...
Pre-duodenal portal vein (PDPV) is a rare anomaly and a rare cause of duodenal obstruction (DO), with only a few cases reported in the literature. We present an infant whose bilious vomiting persisted despite having Ladd's procedure for intestinal malrotation due to a missed diagnosis of DO from PDPV that was found at re-exploration. The patient was diagnosed with malrotation and had Ladd's procedure at 12 weeks of age, but bilious vomiting persisted post-operatively. The patient presented to us after 4 weeks, was clinically malnourished and dehydrated, resuscitation was done and re-exploratory laparotomy performed, where an obstructing PDPV was found and a duodeno-duodenostomy was performed anterior to PDPV. However, the patient died on post-operative day 7 probably from severe malnutrition due to delayed diagnosis and absence of parenteral nutrition. We conclude that PDPV may be a cause of DO in infants with malrotation and should be properly sought for during Ladd's procedure for possible bypass surgery if found.
Topics: Duodenal Obstruction; Humans; Infant; Intestinal Obstruction; Laparotomy; Parenteral Nutrition; Portal Vein; Vomiting
PubMed: 35017382
DOI: 10.4103/ajps.AJPS_146_20