-
World Journal of Gastroenterology Sep 2021Endoscopic resection of duodenal subepithelial lesions (SELs) is a difficult procedure with a high risk of perforation. At present, dealing with perforation after...
BACKGROUND
Endoscopic resection of duodenal subepithelial lesions (SELs) is a difficult procedure with a high risk of perforation. At present, dealing with perforation after endoscopic resection of duodenal SELs is still considered a great challenge.
AIM
To evaluate the effectiveness and safety of an over-the-scope clip (OTSC) in the treatment of perforation post-endoscopic resection of duodenal SELs.
METHODS
From May 2015 to November 2019, 18 patients with perforation following endoscopic resection of duodenal SELs were treated with OTSCs. Data comprising the rate of complete resection, closure of intraprocedural perforation, delayed bleeding, delayed perforation, and postoperative infection were extracted.
RESULTS
The rate of complete removal of duodenal SELs and successful closure of the perforation was 100%. The median perforation size was 1 cm in diameter. Seventeen patients had minor intraoperative bleeding, while the remaining 1 patient had considerable amount of bleeding during the procedure. Seven patients had postoperative abdominal infections, of which 1 patient developed an abscess in the right iliac fossa and another patient developed septic shock. All 18 patients recovered and were discharged. No delayed bleeding or perforation was reported. The mean time taken to resume normal diet after the procedure was 6.5 d. The mean postoperative hospital stay was 9.5 d. No residual or recurrent lesions were detected during the follow-up period (15-66 mo).
CONCLUSION
Closing a perforation after endoscopic resection of duodenal SELs with OTSCs seems to be an effective and reasonably safe therapeutic method.
Topics: Duodenum; Humans; Postoperative Complications
PubMed: 34629812
DOI: 10.3748/wjg.v27.i35.5958 -
Journal of Medical Case Reports Oct 2023Plasmablastic lymphoma is a rare type of non-Hodgkin lymphoma that generally presents an aggressive clinical course. It is strongly associated with human immunodeficency... (Review)
Review
BACKGROUND
Plasmablastic lymphoma is a rare type of non-Hodgkin lymphoma that generally presents an aggressive clinical course. It is strongly associated with human immunodeficency virus (HIV) infection, and the most common site of involvement is the oral cavity. Although extraoral PBL has been reported in several places, small intestine involvement is extremely rare.
CASE PRESENTATION
Here, we describe an exceptionally rare case of a 24-year-old immunocompetent Asian Male patient with newly diagnosed plasmablastic lymphoma of the duodenum. The patient was admitted to our oncology facility due to the patient's clinical course, which included persistent vomiting, hematemesis, weight loss, and generalized weakness. Computed tomography of the abdomen (triphasic) of the patient showed thickness at the 2nd part of the duodenum measuring 2.6 cm in width and 16 cm in length blocking the pancreatic and common bile ducts by entering the second section of the duodenum. The biopsy specimen's pathological investigation indicated abnormal cells with plasmacytoid characteristics and a high proliferation index. The diagnosis of PBL was confirmed by immunohistochemical profiling. Supportive therapies like blood transfusions, antacids, and antiemetics were started to manage the patient's symptoms. Palliative radiation was also anticipated for the lesion site.
CONCLUSIONS
Duodenal involvement to the extent seen in our patient is exceptionally rare and, to the best of our knowledge, has hardly been described. The main goal of the article is to review the literature and report a case.
Topics: Humans; Male; Young Adult; Adult; Plasmablastic Lymphoma; Lymphoma, Large-Cell, Immunoblastic; Duodenum; Lymphoma, Non-Hodgkin; Disease Progression
PubMed: 37777745
DOI: 10.1186/s13256-023-04143-1 -
BMJ Case Reports Feb 2021Kaposiform haemangioendothelioma, an endothelial borderline tumour, is typically seen in childhood involving extremities. It has been closely associated with a...
Kaposiform haemangioendothelioma, an endothelial borderline tumour, is typically seen in childhood involving extremities. It has been closely associated with a consumptive coagulopathy state, Kasabach-Merritt phenomenon (KMP). Extracutaneous involvement is uncommon. Intestinal involvement is quite uncommon and can masquerade as an acute abdomen. A 24-day-old neonate presented with bilious vomiting and fever for 5 days. Sections from the resected gangrenous duodenum contained a submucosal tumour composed of infiltrating nodules of slit-like or crescentic CD34-positive spindled-to-flattened endothelial-lined vascular spaces along with zones of fibrosis. No nuclear pleomorphism or necrosis identified. The findings were classic example of kaposiform haemangioendothelioma with an absence of any deranged coagulation profile. The index case raises interest given its congenital incidental presentation at an uncommon site, like duodenum, and absence of coexistent KMP.
Topics: Diagnosis, Differential; Duodenal Neoplasms; Duodenum; Hemangioendothelioma; Humans; Infant, Newborn; Kasabach-Merritt Syndrome; Radiography; Sarcoma, Kaposi
PubMed: 33608340
DOI: 10.1136/bcr-2020-239527 -
Gastroenterology Oct 2004
Review
Topics: Duodenum; Dyspepsia; Gastric Dilatation; Gastric Emptying; Gastrointestinal Motility; Helicobacter Infections; Helicobacter pylori; Humans; Lipid Metabolism
PubMed: 15481001
DOI: 10.1053/j.gastro.2004.05.030 -
Journal of Virology Oct 2023Enteric adenoviruses have historically been difficult to grow in cell culture, which has resulted in lack of knowledge of host factors and pathways required for...
Enteric adenoviruses have historically been difficult to grow in cell culture, which has resulted in lack of knowledge of host factors and pathways required for infection of these medically relevant viruses. Previous studies in non-intestinal cell lines showed slow infection kinetics and generated comparatively low virus yields compared to other adenovirus types. We suggest duodenum-derived HuTu80 cells as a superior cell line for studies to complement efforts using complex intestinal tissue models. We show that viral host cell factors required for virus entry differ between cell lines from distinct origins and demonstrate the importance of clathrin-mediated endocytosis.
Topics: Humans; Adenoviridae; Clathrin; Duodenum; Endocytosis; Virus Internalization
PubMed: 37823645
DOI: 10.1128/jvi.00770-23 -
Gut Sep 1960Two cases of benign duodeno-colic fistula are described. In the first, no cause was evident, but complete cure of an illness characterized by fatty diarrhoea, loss of...
Two cases of benign duodeno-colic fistula are described. In the first, no cause was evident, but complete cure of an illness characterized by fatty diarrhoea, loss of weight, anaemia, and osteomalacia followed surgical repair. In the second patient cure was spontaneous after a peri-duodenal abscess from a perforated post-bulbar duodenal ulcer discharged into the hepatic flexure of the colon.
Topics: Abscess; Body Weight; Colonic Diseases; Duodenal Diseases; Duodenal Ulcer; Duodenum; Humans; Intestinal Fistula; Male; Medical Records
PubMed: 13692298
DOI: 10.1136/gut.1.3.253 -
Revista Espanola de Enfermedades... Jun 2021Gastric mucosa has been widely studied during the pre/post-Helicobacter pylori (Hp) era. Excluding peptic ulcer disease (PUD), the duodenal mucosa has not been...
Gastric mucosa has been widely studied during the pre/post-Helicobacter pylori (Hp) era. Excluding peptic ulcer disease (PUD), the duodenal mucosa has not been thoroughly analyzed, even less so in functional dyspepsia (FD). We would like to make some comments after studying 161 dyspeptic patients with samples taken from the gastric body, antrum, proximal and distal duodenum.
Topics: Duodenal Ulcer; Duodenum; Dyspepsia; Gastric Mucosa; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans
PubMed: 33393335
DOI: 10.17235/reed.2020.7673/2020 -
Scandinavian Journal of Immunology May 2014The impact of intermittent fasting versus ad libitum feeding during Salmonella typhimurium infection was evaluated in terms of duodenum IgA levels, bacterial clearance...
The impact of intermittent fasting versus ad libitum feeding during Salmonella typhimurium infection was evaluated in terms of duodenum IgA levels, bacterial clearance and intestinal and extra-intestinal infection susceptibility. Mice that were intermittently fasted for 12 weeks or fed ad libitum were infected with S. typhimurium and assessed at 7 and 14 days post-infection. Next, we evaluated bacterial load in the faeces, Peyer's patches, spleen and liver by plate counting, as well as total and specific intestinal IgA and plasmatic corticosterone levels (by immunoenzymatic assay) and lamina propria IgA levels in plasma cells (by cytofluorometry). Polymeric immunoglobulin receptor, α- and J-chains, Pax-5 factor, pro-inflammatory cytokine (tumour necrosis factor-α and interferon-γ) and anti-inflammatory cytokine (transforming growth factor-β) mRNA levels were assessed in mucosal and liver samples (by real-time PCR). Compared with the infected ad libitum mice, the intermittently fasted infected animals had (1) lower intestinal and systemic bacterial loads; (2) higher SIgA and IgA plasma cell levels; (3) higher mRNA expression of most intestinal parameters; and (4) increased or decreased corticosterone levels on day 7 and 14 post-infection, respectively. No contribution of liver IgA was observed at the intestinal level. Apparently, the changes following metabolic stress induced by intermittent fasting during food deprivation days increased the resistance to S. typhimurium infection by triggering intestinal IgA production and presumably, pathogen elimination by phagocytic inflammatory cells.
Topics: Animals; Bacterial Load; Corticosterone; Cytokines; Duodenum; Fasting; Feces; Gene Expression Regulation; Immunity, Mucosal; Immunoglobulin A; Male; Mice; Mice, Inbred BALB C; PAX5 Transcription Factor; Plasma Cells; Salmonella Infections; Salmonella typhimurium; Stress, Physiological
PubMed: 24612255
DOI: 10.1111/sji.12163 -
Archives of Pathology & Laboratory... Dec 2006Strongyloidiasis is a worldwide parasitic infection affecting approximately 75 million people. In Italy, it was more prevalent in the past among rural populations of...
CONTEXT
Strongyloidiasis is a worldwide parasitic infection affecting approximately 75 million people. In Italy, it was more prevalent in the past among rural populations of irrigated areas.
OBJECTIVE
To determine the histopathologic alterations of the gastric and duodenal mucosa associated with the presence of Strongyloides stercoralis parasites.
DESIGN
Fifteen cases of strongyloidiasis were observed in immunocompromised patients during a recent 6-year period in Italy. S. stercoralis was found histologically in gastric biopsies (10 cases), in a gastrectomy (1 case), and in duodenal biopsies (9 cases). In 5 cases the parasite was present both in gastric and duodenal biopsies. Four patients were affected by lymphoma, 2 by multiple myeloma, 2 by gastric carcinoma, 1 by chronic myeloid leukemia, 1 by sideroblastic anemia, 1 by colorectal adenocarcinoma, 1 by chronic idiopathic myelofibrosis, 1 by chronic gastritis, 1 by gastric ulcers, and 1 by rheumatoid arthritis in corticosteroid therapy. No patient was affected by human immunodeficiency virus infection. Strongyloidiasis was not clinically diagnosed.
RESULTS
Histologic examination revealed several sections of S. stercoralis larvae, many eggs, and some adult forms. All the parasites were located in the gastric and/or the duodenal crypts. Eosinophils infiltrating into the lamina propria were found in all cases; their intensity was correlated with the intensity of the infection.
CONCLUSIONS
Histologic diagnosis of strongyloidiasis must be taken into consideration when examining both gastric and duodenal biopsies in immunocompromised patients, to avoid the development of an overwhelming infection of the parasite, which is dangerous for the life of the patient.
Topics: Aged; Aged, 80 and over; Animals; Biopsy; Duodenal Diseases; Duodenum; Female; Humans; Immunocompromised Host; Life Cycle Stages; Male; Middle Aged; Stomach; Stomach Diseases; Strongyloides stercoralis; Strongyloidiasis
PubMed: 17149952
DOI: 10.5858/2006-130-1792-HOGADS -
Frontiers in Cellular and Infection... 2017What is already known about this subject?Celiac disease (CD) has a high clinical and histological diversity and the mechanisms underlying this phenomenon remain...
What is already known about this subject?Celiac disease (CD) has a high clinical and histological diversity and the mechanisms underlying this phenomenon remain elusive. is a bacterium that chronically infect gastric and duodenal mucosa activating both a Th1/Th17 and T-reg pathways.The role of (and the effect of their virulence factors) in CD have not yet completely elucidated.What are the new findings?+ strains are associated to milder histological damage in infected CD patients.In active-CD patients the presence of + is associated to an increase in T-reg markers, contrasting with a downregulation in + infected potential-CD individuals.How might it impact on clinical practice in the foreseeable future?The identification of microbiological factors that could modulate inflammation and clinical expression of CD may be used in the future as preventive strategies or as supplementary treatment in patients that cannot achieve complete remission, contributing to the better care of these patients. Mechanisms underlying the high clinical and histological diversity of celiac disease (CD) remain elusive. (Hp) chronically infects gastric and duodenal mucosa and has been associated with protection against some immune-mediated conditions, but its role (specifically of + strains) in CD is unclear. To assess the relationship between gastric Hp infection (+ strains) and duodenal histological damage in patients with CD. Case-control study including patients with active-CD, potential-CD and non-celiac individuals. Clinical presentation, HLA genotype, Hp/ gene detection in gastric mucosa, duodenal histology, Foxp3 positive cells and TGF-β expression in duodenal lamina propria were analyzed. We recruited 116 patients, 29 active-CD, 37 potential-CD, and 50 non-CD controls. Hp detection was similar in the three groups (~30-40%), but + strains were more common in infected potential-CD than in active-CD (10/11 vs. 4/10; = 0.020) and non-CD (10/20; = 0.025). Among active-CD patients, Foxp3 positivity was significantly higher in subjects with + Hp+ compared to Hp+ ( < 0.01) and Hp- ( < 0.01). In cagA+ Hp+ individuals, Foxp3 positivity was also higher comparing active- to potential-CD ( < 0.01). TGF-β expression in duodenum was similar in active-CD with + Hp+ compared to Hp- and was significantly downregulated in + potential-CD subjects compared to other groups. Hp infection rates were similar among individuals with/without CD, but infection with + strains was associated with milder histological damage in celiac patients infected by Hp, and in active-CD cases with higher expression of T-reg markers. Results suggest that infection by + Hp may be protective for CD progression, or conversely, that these strains are prone to colonize intestinal mucosa with less severe damage.
Topics: Adolescent; Adult; Antigens, Bacterial; Bacterial Proteins; Case-Control Studies; Celiac Disease; Child; Child, Preschool; Chile; Duodenum; Female; Forkhead Transcription Factors; Gastric Mucosa; Genes, Bacterial; Genotype; Helicobacter Infections; Helicobacter pylori; Humans; Infant; Male; Middle Aged; Transforming Growth Factor beta; Virulence Factors; Young Adult
PubMed: 28879170
DOI: 10.3389/fcimb.2017.00376