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Journal of Visualized Experiments : JoVE Dec 2023Duodenal stenosis is a condition that can be related to several diseases, being either intrinsic, such as neoplasm and inflammatory stenosis, or extrinsic, such as...
Duodenal stenosis is a condition that can be related to several diseases, being either intrinsic, such as neoplasm and inflammatory stenosis, or extrinsic, such as pancreatic pseudocyst, superior mesenteric artery syndrome, and foreign bodies. Current treatments range from endoscopic approaches, such as endoscopic resection and stent placement, to surgical approaches, including duodenal resection, pancreaticoduodenectomy, and gastrointestinal bypass. Minimally invasive robot-assisted surgery is gaining importance due to its potential to decrease surgical stress, intraoperative blood loss, and postoperative pain, while its instruments and 3D-vision facilitate fine dissection and intra-abdominal suturing, all leading to a reduced time to functional recovery and shorter hospital stay. We present a case of a 75-year-old female who underwent robotic D3 partial duodenal resection with primary side-to-side duodeno-jejunal anastomosis for a 5 cm adenoma with focal high-grade dysplasia.
Topics: Female; Humans; Aged; Robotic Surgical Procedures; Duodenum; Robotics; Anastomosis, Surgical; Pancreaticoduodenectomy; Laparoscopy
PubMed: 38163262
DOI: 10.3791/65742 -
Evidence-based Complementary and... 2023[This retracts the article DOI: 10.1155/2022/2662435.].
[This retracts the article DOI: 10.1155/2022/2662435.].
PubMed: 38125131
DOI: 10.1155/2023/9819473 -
JPGN Reports Nov 2023Duodenal stenosis is a rare congenital anomaly that is typically treated surgically, although endoscopic incisional therapy (EIT) and balloon dilation are minimally...
Duodenal stenosis is a rare congenital anomaly that is typically treated surgically, although endoscopic incisional therapy (EIT) and balloon dilation are minimally invasive alternatives. We present a case of a 15-month-old male with vomiting and difficulty tolerating solid food due to severe congenital duodenal stenosis. The patient underwent EIT and serial duodenal dilation to a diameter of 20 mm, which resulted in significant symptom improvement. Intralesional corticosteroid injection (ISI) was administered to help prevent the duodenal septum from restricturing. The combination of EIT, balloon dilation, and ISI was successful in treating the patient's congenital duodenal stenosis and avoided the need for surgery. However, further studies are required to confirm the efficacy of this treatment approach in this patient population. This report highlights the potential of this minimally invasive approach as an alternative to surgical intervention in the management of congenital duodenal stenosis.
PubMed: 38034463
DOI: 10.1097/PG9.0000000000000347 -
Zhonghua Yi Xue Yi Chuan Xue Za Zhi =... Dec 2023To explore the genetic basis for three fetuses with duodenal atresia or stenosis detected by ultrasonography.
OBJECTIVE
To explore the genetic basis for three fetuses with duodenal atresia or stenosis detected by ultrasonography.
METHODS
Clinical data of three fetuses identified at the Women's Hospital Affiliated to Zhejiang University School of Medicine between January 2021 and August 2022 were collected. Umbilical cord blood and amniotic fluid samples of the fetuses and peripheral blood samples of their parents were collected and subjected to G-banded chromosomal karyotyping and single nucleotide polymorphism array (SNP array) analysis.
RESULTS
Prenatal ultrasound of the three fetuses revealed duodenal atresia or stenosis. No karyotypic abnormality was detected, whilst SNP array has identified 1.4 ~ 1.9 Mb duplications at 17q12 in all of them, which were all predicted to be pathogenic copy number variations (CNVs).
CONCLUSION
The 17q12 duplications probably underlay the duodenal atresia and stenosis in these fetuses, and chromosomal CNVs should be considered in duodenal atresia and stenosis.
Topics: Pregnancy; Humans; Female; DNA Copy Number Variations; Constriction, Pathologic; Prenatal Diagnosis; Fetus; Chromosome Aberrations
PubMed: 37994128
DOI: 10.3760/cma.j.cn511374-20221115-00788 -
Medicine Nov 2023Duodenal ulcer bleeding is a potentially life-threatening condition commonly caused by the erosion of the duodenal arteries.
RATIONALE
Duodenal ulcer bleeding is a potentially life-threatening condition commonly caused by the erosion of the duodenal arteries.
PATIENT CONCERNS
A 55-year-old male was referred to our hospital with abdominal pain for the past 3 days. Contrast-enhanced computed tomography of the abdomen revealed wall thickening in the descending part of the duodenum and a cystic lesion (27 × 19 mm) contiguous with the duodenum, with an accumulation of fluid. An esophagogastroduodenoscopy showed the significantly stenotic duodenum, which prevented passage of the endoscope and evaluation of the main lesion. Based on these findings, duodenal ulcer perforation and concomitant abscess formation were suspected. Two days after admission, he had massive hematochezia with bloody drainage from the nasogastric tube.
DIAGNOSES
Emergency angiography revealed duodenal ulcer bleeding from the gastroduodenal artery and the branch artery of the inferior pancreaticoduodenal artery and middle colic artery (MCA).
INTERVENTIONS
The patient was treated with transcatheter arterial embolization (TAE) of the gastroduodenal artery, the branch vessel of the inferior pancreaticoduodenal artery, and the main trunk of the MCA.
OUTCOMES
Hemostasis was achieved with TAE. The patient recovered uneventfully and undergone a gastro-jejunal bypass surgery for the duodenal stenosis 2 weeks after TAE. He was discharged without any abnormal complaints on postoperative day 12.
LESSONS
We have experienced a rare case of duodenal ulcer bleeding from a branch of the MCA. In patients with refractory upper gastrointestinal bleeding, careful evaluation of bleeding sites is recommended considering unexpected culprit vessels.
Topics: Male; Humans; Middle Aged; Duodenal Ulcer; Mesenteric Artery, Inferior; Peptic Ulcer Hemorrhage; Duodenum; Gastrointestinal Hemorrhage; Mesenteric Artery, Superior; Embolization, Therapeutic
PubMed: 37933022
DOI: 10.1097/MD.0000000000035955 -
Revista Espanola de Enfermedades... Nov 2023A 66-year-old man presented with repeated vomiting for 5 days. Initial gastroscopy showed gastric retention while computed tomography (CT) revealed a 1.8*1.1 cm,...
A 66-year-old man presented with repeated vomiting for 5 days. Initial gastroscopy showed gastric retention while computed tomography (CT) revealed a 1.8*1.1 cm, oval-shaped, high-density object in the duodenum. Considering his past medical history of a surgical repair for duodenal ulcer perforation 20 years ago, a diagnosis of foreign body (FB) impaction causing gastric outlet obstruction was established. After gastric lavage, a second gastroscopy was performed. A brownish round FB impacted upon scarring stenoses at the junction of the 1st and 2nd part of duodenum was visualized after advancement of the scope with effort through a deformed pylorus. Attempts to capture the FB using a polypectomy snare failed because the snare loop could not be advanced across the stenotic impaction site to allow adequate opening. A grasper was also ineffective due to the smooth surface of the FB. Then the ERCP stone extraction technique was applied. Directed by the adjustable tip of a sphincterotome which was introduced through the same gastroscope, a guidewire passed with little resistance over the impaction site for an adequate length. Subsequently, an extraction balloon was advanced through the guidewire with slight inflation to avoid injury to the stenotic duodenal wall and fully inflated in the distal lumen. Gradual balloon deflation and withdrawal applied simultaneously achieved successful removal of the BF, which was identified as an apricot pit. The patient resumed his diet of soft food immediately after the procedure without complaint of any discomfort.
PubMed: 37929959
DOI: 10.17235/reed.2023.10019/2023 -
IJU Case Reports Nov 2023Gastric outlet obstruction caused by upper tract urothelial carcinoma is rare.
INTRODUCTION
Gastric outlet obstruction caused by upper tract urothelial carcinoma is rare.
CASE PRESENTATION
A 78-year-old man presented to the hospital with nausea and vomiting. No hematuria was observed. Computed tomography revealed a tumor in the right renal pelvis and duodenal stenosis. Gastrojejunostomy was performed to treat the symptoms of the gastric outlet obstruction so that the patient could resume oral intake and outpatient chemotherapy. Chemotherapy was unsuccessful, and the patient died 9 months after the gastrojejunostomy. Histological assessment of an autopsy specimen revealed plasmacytoid urothelial carcinoma with direct infiltration of the duodenal wall, which caused the stenosis.
CONCLUSION
Autopsy revealed a right renal pelvis cancer causing gastric outlet obstruction. Early gastrojejunostomy enabled oral intake and outpatient visits.
PubMed: 37928298
DOI: 10.1002/iju5.12652 -
Gastroenterologia Y Hepatologia Nov 2023
PubMed: 37923082
DOI: 10.1016/j.gastrohep.2023.10.007 -
The Journal of International Medical... Oct 2023Duodenal stenosis caused by upper tract urothelial carcinoma (UTUC) is rare. A 70-year-old male patient was diagnosed with a UTUC invading the duodenum 3 months before...
Duodenal stenosis caused by upper tract urothelial carcinoma (UTUC) is rare. A 70-year-old male patient was diagnosed with a UTUC invading the duodenum 3 months before admission. Owing to duodenal stenosis, enteral nutrition was necessary. We performed pancreaticoduodenectomy with right nephroureterectomy and right hemicolectomy using a multi-disciplinary approach. Postoperative pathology revealed a UTUC invading the right kidney, duodenum, pancreas, and transverse colon. The patient underwent chemotherapy and immunotherapy after surgery, which improved his quality of life.
Topics: Male; Humans; Aged; Carcinoma, Transitional Cell; Urinary Bladder Neoplasms; Quality of Life; Nephroureterectomy
PubMed: 37899573
DOI: 10.1177/03000605231206958 -
Frontiers in Veterinary Science 2023Abomasal ulcers, an economic concern for all calf-raising farms, are usually silent until perforation occurs, at which time management is complicated and often...
Abomasal ulcers, an economic concern for all calf-raising farms, are usually silent until perforation occurs, at which time management is complicated and often unrewarding. This case study describes perforating ulcer in a 3-day-old Brahman heifer, occurring secondary to a congenital narrowing of the pylorus and proximal duodenum and leading to marked abomasal distention, leakage, and eventual peritonitis and sepsis.
PubMed: 37885618
DOI: 10.3389/fvets.2023.1235110