Cases reported "Duodenal Ulcer"

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1/100. Duodenal ulceration into the cystic artery with massive hemorrhage.

    This is a case presentation of a unique cause of intestinal bleeding. A duodenal ulcer eroded into the superficial branch of the cystic artery, causing massive intestinal hemorrhage. The patient, a 76-year-old woman, presented with left upper abdominal and left back pain secondary to cystic lesions in the pancreas body and tail. Stress after operation and complication of leakage of pancreatic juice after distal pancreatectomy with splenectomy and diclofenac sodium administration may have caused a deep peptic ulcer to erode the cystic artery. We performed a transfixing ligation of the bleeding vessel, serosal suture of ulcer of the gallbladder, and simple closure of the duodenal ulcer with covering greater omentum. There were no serious complications after the operation, and the patient made an uneventful recovery.
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ranking = 1
keywords = back pain, upper, back
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2/100. Direct sonographic signs of acute duodenal ulcer.

    Sonography was performed in two patients with acute epigastric pain. Isolated thickening of the duodenal wall with an echogenic line within were considered to be signs of duodenal ulcer in keeping with a suggestive clinical background. The extension of this line beyond the duodenal wall and the periduodenal fluid were indicators of perforation. The images in our two patients indicate the usefulness of ultrasonography when performed carefully in selected cases.
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ranking = 0.028308682214304
keywords = back
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3/100. Malabsorption with progressive weight loss and multiple intestinal ulcers in a patient with T-cell lymphoma.

    We describe a 52-year-old woman who presented with severe diarrhea, nausea, intermittent abdominal pain and weight loss of 18 kg within ten months. Jejunal and duodenal ulcers were detected by endoscopy and multiple biopsies revealed villous atrophy of the jejunum. However, neither gliadin nor endomysium antibodies were detected and no clinical and histological improvement was achieved after gluten withdrawal. Despite strong clinical suspicion for intestinal lymphoma many unrevealing biopsies were done. The patient developed intermittent septic fever and diagnostic laparotomy revealed jejunal perforation. Partial jejunal resection was performed and histology confirmed the diagnosis of an intestinal T-cell lymphoma without celiac disease. Malabsorption and all intestinal ulcers disappeared during the course of chemotherapy (six cycles CHOP) and the patient recovered remarkably.
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ranking = 1.4056003344623
keywords = abdominal pain
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4/100. Relapse of duodenal ulcers after successful eradication of helicobacter pylori in gastric ulcer patients.

    Relapse of duodenal ulcers was observed endoscopically after helicobacter pylori eradication therapy for gastric ulcer patients in 2 of 32 successful cases. One patient, a 40-year-old woman, received dual therapy with lansoprazole 60mg and amoxicillin 1000mg for 2 weeks because of an intractable, easily-relapsing gastric ulcer accompanied by duodenal ulcer scars that had not relapsed for 5 years. The H. pylori status was assessed by a rapid urease test, light microscopy, culture, and anti-H. pylori antibody. At 24 months after the cure of H. pylori she had upper abdominal pain and showed relapse not of the gastric ulcer but of the duodenal ulcer. The H. pylori status remained negative. The other patient, a 44-year-old man, showed an active gastric ulcer and duodenal ulcer scars at the first endoscopy. He received the same regimen as described above. Ten weeks after completion of the eradication therapy, endoscopy showed healing of the gastric ulcer and relapse of the duodenal ulcer despite successful eradication. These two cases suggest that H. pylori eradication modifies the pathophysiological condition of gastric acid secretion and facilitates relapse of duodenal ulcers.
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ranking = 76.438716688193
keywords = upper abdominal pain, abdominal pain, upper
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5/100. Acute upper gastrointestinal bleed: a case study.

    Upper gastrointestinal (UGI) bleeding on a presenting symptom is of major significance for nurse practitioners in any clinical setting. Bleeding in the upper gastric tract is a symptom of a disease process rather than a disease in itself. UGI bleeding accounts for 300,000 hospitalizations annually. An astute knowledge of the pathophysiology and clinical presentations of UGI bleeding enables swift intervention and a reduction in morbidity and mortality rates. This article presents a case report of a white male in his fifties diagnosed with metastatic colon cancer and acute UGI bleeding and emphasizes the need for early screening and detection, disease education, and prompt interventions to minimize associated complications.
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ranking = 2.3110652076392
keywords = upper
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6/100. Sonographic diagnosis of a small fistulous communication between a subphrenic abscess and a perforated duodenal ulcer.

    We report a case of a fistula between a subphrenic abscess and a perforated duodenal ulcer diagnosed by sonography and confirmed by CT. The sonographic findings included a subphrenic fluid collection connected to the anterior aspect of the superior duodenum by a nonpulsatile, anechoic tubular lesion. Manual compression of the upper epigastrium resulted in movement of echogenic debris from the antrum and superior duodenum through the fistulous tract into the abscess.
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ranking = 0.46221304152784
keywords = upper
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7/100. Near-fatal hemorrhage following gastrografin studies.

    The use of upper gastrointestinal studies followed by gastric drainage and observation is recommended for the evaluation and treatment of stomal dysfunction due to edema or gastric atony. Gastrografin though, may be precipitated out and can cause gastrointestinal bleeding if left in the gastric remenant. This agent should be used with proper precautions in the evaluation of postoperative gastric retention.
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ranking = 0.46221304152784
keywords = upper
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8/100. Prevention of upper gastrointestinal hemorrhage in 582 burned children.

    In 582 burned children, neutralization of gastric acid and reduction of psychic stress were utilized to reduce upper gastrointestinal ulceration and hemorrhage. While receiving milk, diazepam, and psychologic support, two children required operation. Two of the children who died without clinically apparent gastrointestinal disease had ulcers discovered at autopsy. We conclude that a prophylactic regimen that reduced the amount of acid bathing the gastroduodenal mucosa, provides adequate calories, and minimizes psychic stress is useful in preventing gastrointestinal hemorrhage after burns.
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ranking = 2.3110652076392
keywords = upper
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9/100. Intercostal arteriovenous hemangioma.

    We report a case of a 46-year-old man who presented with a chest wall tumor in the right hemithorax. He underwent thoracotomy to remove the mass, which was found to be an arteriovenous hemangioma arising from the intercostal muscle. Arteriovenous hemangioma is a rare tumor and chest wall is an extremely rare site for this tumor. This tumor should be considered in the differential diagnosis of the chest wall tumors. Complete surgical excision offers the best treatment.
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ranking = 0.023186768865412
keywords = chest
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10/100. Bouveret's syndrome presenting as upper gastrointestinal hemorrhage without hematemesis.

    A 74-year-old woman with a recent diagnosis of peptic ulcer disease diagnosed by endoscopy after presentation with an episode of upper gastrointestinal bleeding returned 6 1/2 weeks later with a 5-day history of nausea and vomiting without associated symptoms. An ultrasound was nondiagnostic except for a large gallstone and a poorly visualized gallbladder. Repeat endoscopy revealed a hard mass that was presumed to have formed secondarily to an ulcer-induced stricture, and a 6-cm filling defect just proximal to the duodenal bulb was seen on a preoperative upper gastrointestinal series. At laparotomy the mass was actually a large gallstone and two smaller stones, which had eroded into and become impacted in the duodenal bulb creating a gastric outlet obstruction. The stones were extracted via a duodenotomy, and the remaining portion of the gallbladder was removed with repair of the cholecystoduodenal fistula. The patient was discharged home after an uncomplicated postoperative course. gastric outlet obstruction by a duodenal gallstone is a condition known as Bouveret's syndrome, which is a rare complication of gallstone disease. Upper gastrointestinal hemorrhage is an especially rare form of presentation.
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ranking = 2.773278249167
keywords = upper
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