Cases reported "Duodenal Diseases"

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1/121. Laparoscopic drainage of an intramural duodenal hematoma.

    A 21-year-old man was admitted with vomiting and abdominal pain 3 days after sustaining blunt abdominal trauma by being tackled in a game of American football. A diagnosis of intramural hematoma of the duodenum was made using computed tomography and upper gastrointestinal tract contrast radiography. The hematoma caused obstructive jaundice by compressing the common bile duct. The contents of the hematoma were laparoscopically drained. A small perforation was then found in the duodenal wall. The patient underwent laparotomy and repair of the injury. Laparoscopic surgery can be used as definitive therapy in this type of abdominal trauma.
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ranking = 1
keywords = abdominal pain
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2/121. Systemic amyloidosis and sacroiliitis in a patient with systemic lupus erythematosus.

    We report a case of a 25-year-old female with juvenile onset systemic lupus erythematosus who developed systemic secondary amyloidosis with renal and gastrointestinal involvement. She has also had radiological signs of bilateral asymptomatic sacroiliitis without lower back pain or hla-b27 antigen.
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ranking = 0.015391744629459
keywords = back pain, back
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3/121. gallbladder carcinoma with choledochoduodenal fistula: a case report with surgical treatment.

    A 79 year-old man was admitted to our hospital because of upper abdominal pain and nausea. A mobile tumor was palpable in the right upper abdomen. Abdominal ultrasonography, computed tomography and celiac angiography revealed a gallbladder tumor. Endoscopic retrograde cholangiopancreatography revealed a fistula 1.5 cm oral to the orifice of the papilla of Vater, dilatation of the common bile duct, and a filling defect in the gallbladder. Pancreatoduodenectomy associated with reconstruction using Imanaga's method was performed under a pre-operative diagnosis of gallbladder carcinoma with choledochoduodenal fistula. The gallbladder contained a tumor and two bilirubin stones impacted in the orifice of the duodenal papilla. Histological studies confirmed that the gallbladder tumor was a mucinous adenocarcinoma and had not infiltrated the bile duct. We speculated that choledochoduodenal fistula stimulated the development of cancer due to chronic irritation from pancreatic juice reflux.
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ranking = 11.277631668565
keywords = upper abdominal pain, abdominal pain
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4/121. Brunner's gland hamartomas: report of three cases.

    Brunner's gland hamartoma is a rare duodenal tumor, which grew larger than 2 cm in diameter in a very limited number of cases. Since the first description in a patient with fatal duodenal intussusception by Cruveilhier in 1835, approximately 143 cases have been reported in the English literature, and only 25 cases had tumor growth to more than 2 cm in diameter. To the best of our knowledge, only 4 cases have been reported in taiwan. We present three of Brunner's gland hamartomas. In one patient the tumor was located on the secondary portion of the duodenum, which presented with massive tumor bleeding and measured 3.0 cm in diameter. The other two were both located on the duodenal bulb, which presented with abdominal pain and measured 2.0 and 1.3 cm in diameter, respectively. One of the patients received endoscopic ultrasonography which showed specific findings. Two patients received laparotomy and tumor excision; the other one received endoscopic polypectomy. All 3 patients recovered well without any complications.
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ranking = 1
keywords = abdominal pain
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5/121. Paraduodenal hernia presenting as unexplained recurrent abdominal pain.

    We present a case of a 29-yr-old female nurse who presented with an 8-h history of abdominal pain. She had had similar episodes (twice/yr) over the last 5 yr, and the pain had usually resolved spontaneously. Prior investigations including laboratory studies, plain films of the abdomen, an abdominal and pelvic ultrasound, and a CT scan yielded no diagnosis. Her pain was previously considered to be either psychosomatic or a variant of irritable bowel syndrome. On this admission, an evaluation and subsequent enteroclysis revealed a left paraduodenal hernia. The importance of considering paraduodenal hernias in the differential diagnosis of unexplained intermittent abdominal pain is discussed here.
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ranking = 6
keywords = abdominal pain
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6/121. afferent loop syndrome presenting as enterolith after Billroth II subtotal gastrectomy: a case report.

    We present a rare late-onset (after 24 years) complication of gastric surgery with a combination of afferent loop syndrome associated with a large duodenal stone. The patient, who had undergone Billroth II partial gastrectomy for benign ulcer 24 years before, developed abdominal pain in the right upper quadrant, associated with nausea, vomiting, and high grade fever. Abnormal laboratory values included elevated liver function test, suggesting a pressure-related phenomenon. leukocytosis and a high level of platelets were also found. Only computed tomography and endoscopy of the upper gastrointestinal tract confirmed the diagnosis of a huge stone in the dilated duodenal afferent loop. To our knowledge, a case like this has not been reported previously in the literature.
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ranking = 1
keywords = abdominal pain
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7/121. Aortoduodenal fistula presenting as acute massive gastrointestinal bleeding and recurrent syncope: case report.

    Aortoenteric fistula is a rare condition that may cause death in patients due to gastrointestinal bleeding. The duodenum is the most frequently involved site, at 78.5% of 191 cases by Nagy and Marshall's meta-analysis. It is characterized by the clinical triad of abdominal pain, gastrointestinal bleeding, and an abdominal mass. Abdominal computed tomography is the most useful tool in detecting an aortoenteric fistula. To prevent a high mortality rate, early diagnosis is necessary. Exploratory laparotomy is required for patients who are highly suspected of having an aortoduodenal fistula. Herein, we report a 60-year-old man who suffered from acute gastrointestinal bleeding, recurrent syncope, and impending shock. Abdominal computed tomography revealed a 6 cm longitudinal aneurysm in the infrarenal aorta. Emergency laparotomy was performed and revealed an aortoduodenal fistula in the fourth portion of the duodenum causing acute duodenal bleeding. The patient survived and has undergone 2 years worth of regular follow-up in our outpatient department.
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ranking = 1
keywords = abdominal pain
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8/121. A case of aortoduodenal fistula occurring after surgery and radiation for pancreatic cancer.

    The patient was a 58-year-old woman given curative treatment (pancreatectomy (body and tail) intraoperative irradiation (25 Gy)) on the basis of a diagnosis of pancreatic carcinoma. Having a favorable postoperative course, she was discharged 24 days after surgery. A week after discharge, she was readmitted for a hemorrhagic gastric ulcer. She was later discharged again on conservative treatment, and followed up at the outpatient clinic, but nine months postoperatively, was readmitted complaining of loss of appetite and abdominal pain. Subsequent tests revealed stricture of the horizontal portion of the duodenum with distension oral to the stricture. Around the celiac artery, the paraaortic lymph nodes were swollen, and a diagnosis of stricture due to recurrent pancreatic carcinoma was made. On the day before bypass surgery was scheduled, the patient vomited blood, so the operation was postponed, conservative treatment such as blood transfusion was administered, and emergency angiography was performed simultaneously. The findings were an aortic pseudoaneurym 1 cm in diameter immediately below the origin of the superior mesenteric artery and between the left and right renal arteries, and a hemorrhage, caused by an aortoduodenal fistula, issuing from the horizontal portion of the duodenum. hemostasis via a laparotomy was judged difficult, and so an indwelling stent-graft in the aorta was tried to stanch the blood, but without success. Another stent then had to be inserted within the first, thus stopping the flow, but the blood supply to the celiac artery, the superior mesenteric arteries and the renal arteries was impaired, and the patient died about six hours later. Postmortem examination revealed aortoduodenal fistula without recurrence of the carcinoma. The duodenal wall around the fistulous tract showed delayed radiation changes with deep ulceration. The intraoperative radiation may have played an important part in the formation of the fistula.
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ranking = 1
keywords = abdominal pain
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9/121. The late nonfunctioning duodenal atresia repair--a second look.

    BACKGROUND/PURPOSE: In 1986, the authors reported on 3 newborns who had repair of their duodenal atresia, and between 6 and 18 months postoperatively an anastomotic obstruction developed in each suddenly. After prolonged medical and surgical treatments it became apparent that the duodenal atresia repair was functionally obstructed and plication of the dilated atonic proximal duodenum was curative. Since then, 2 more patients became so obstructed at 5 and 24 years postoperatively. The aim of this study was to report the very late occurrence of a functional obstruction of a newborn duodenal atresia repair. methods: The 2 additional histories and surgical repairs were reviewed. RESULTS: The 5-year old boy was cured immediately with plication only of his dilated proximal duodenum. The 24-year-old nurse had a very stormy 2-year course with several bypass operations, which did not relieve her abdominal pain and bile vomiting until they were taken down and her dilated proximal duodenum was plicated, after which she made a good recovery. Both remain well. CONCLUSION: An uncommon, very late, sudden, apparently anastomotic, postoperative, newborn, duodenal atresia repair obstruction caused by proximal, dilated, duodenal atony, and dysfunction can occur many years later and responds to duodenal plication alone.
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ranking = 1
keywords = abdominal pain
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10/121. Superior mesenteric venous thrombosis in malrotation with chronic volvulus.

    Malrotation can be difficult to diagnose after the newborn period because of intermittent symptoms and vague clinical findings, but malrotation with midgut volvulus is usually quite striking in its presentation. early diagnosis and surgical treatment are essential to prevent acute ischemic infarction of the bowel, although chronic complications are rare. The authors present an unusual case of mesenteric venous thrombosis secondary to chronic midgut volvulus. A 13-year-old girl presented with an 11-year history of recurrent bouts of abdominal pain evaluated at 3 other institutions without a diagnosis. At the referring hospital, an episode of bilious emesis associated with abdominal pain prompted a computerized tomography scan of the abdomen. This showed a calcified thrombus within the superior mesenteric vein (SMV). At laparotomy, malrotation with chronic 270 degree volvulus was found with evidence of mesenteric venous hypertension. Segmental occlusion was documented on magnetic resonance angiography. SMV thrombosis is an unusual complication of malrotation with chronic midgut volvulus.
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ranking = 2
keywords = abdominal pain
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