1/13. A rare case of multiple carcinoids and endocrine cell micronests in a patient with chronic duodenitis.BACKGROUND: To the authors' knowledge, multiple carcinoid tumors of the duodenum have not been reported previously. However, multiple carcinoids in the stomach, ileum, and rectum, which were accompanied by the proliferation of endocrine cells, have been reported in the published literature. methods: A patient with multiple carcinoids including argyrophilic cell hyperplasia of the duodenum and hypergastrinemia underwent surgery. The resected stomach and duodenum were analyzed histopathologically. RESULTS: There were 11 carcinoid lesions, each of which was accompanied by peripheral endocrine cell micronests (ECMs). Increasing gastrin positive cells in the antral region and chronic duodenitis in the duodenal bulb also were observed. The peripheral ECMs usually were adjacent to proliferating argyrophilic cells in the Brunner gland ducts or the crypts of Lieberkuhn, which showed focal pyloric gland metaplasia. CONCLUSIONS: In the case presented in the current study, the development of the multiple carcinoid lesions may be strongly related to the presence of multifocal pyloric gland metaplasia, as well as to the trophic action of gastrin, which is present at high levels in the setting of chronic duodenitis.- - - - - - - - - - ranking = 1keywords = duct (Clic here for more details about this article) |
2/13. mortality during the winter flu epidemic--two cases of death associated with self-medication.We report two cases of mortality associated with the recent winter influenza outbreak. Both cases were associated with self-medication. In one case an elderly lady died from haemorrhagic duodenitis induced by over the counter ibuprofen. In the second case the lady died from the consequences of exceeding the recommended doses of paracetamol by combining doses of the generic product with proprietary flu-remedies and Tylex (paracetamol and codeine).- - - - - - - - - - ranking = 1keywords = duct (Clic here for more details about this article) |
3/13. Acute cholecystitis and duodenitis associated with churg-strauss syndrome.We describe a patient with acute cholecystitis and duodenitis associated with churg-strauss syndrome. A 36-year-old male, who had been healthy, had abdominal pain following high fever. He had marked hypereosinophilia of 17,000/mm3. Radiographs of the chest disclosed a transient infiltrated lesion in the left lower lung. Ultrasonographic and gastroendoscopic examinations revealed acute cholecystitis and duodenitis, respectively. Endoscopic retrograde cholangiopancreatography demonstrated a filling defect suspecting aberrant ascariasis in the common bile duct. The patient suddenly developed distally dominant mononeuritis multiplex, especially in the upper limbs. Muscle biopsy revealed vasculitis of intramuscular arteries with infiltration of eosinophils. These findings fulfilled the diagnostic criteria of churg-strauss syndrome. Corticosteroid dramatically resolved the abdominal symptoms. cholecystectomy and removal of the foreign body were performed. Histological examinations revealed that necrosis of the gallbladder was caused by occlusion due to thrombosed arteries and that the foreign body in the common bile duct was an aggregate of necrotic epithelium of the bile duct wall surrounded by inflammatory cells. Although abdominal complaints rarely appeared as an initial symptom in the patients with churg-strauss syndrome, this syndrome should be taken into consideration for an accurate diagnosis when the patients with abdominal pain of unknown origin had eosinophilia, asthma, or allergic rhinitis.- - - - - - - - - - ranking = 37.84414983525keywords = bile duct, bile, duct (Clic here for more details about this article) |
4/13. Duodenal atresia presenting as hematemesis in a premature infant with down syndrome. Case report and review of the literature.Congenital duodenal obstruction, a common complication of down syndrome, most often presents as neonatal bilious vomiting. We report the first premature infant with down syndrome whose duodenal atresia presented with a massive hematemesis secondary to duodenitis. Since a plain radiograph of the abdomen is diagnostic in the case of duodenal obstruction, it should be included in the diagnostic workup of hematemesis in newborn infants.- - - - - - - - - - ranking = 3.268236162143keywords = obstruction (Clic here for more details about this article) |
5/13. Crohn's disease of the duodenum complicated by pancreatitis and common bile duct obstruction.It is well known that Crohn's disease can involve the duodenum, but isolated secondary complications such as pancreatitis or common bile duct obstruction have only rarely been reported, and never in the same patient. Herein, we describe a patient with duodenal Crohn's disease and both pancreatitis and calculous common bile obstruction. This unusual constellation of findings was managed with percutaneous techniques in which transhepatic catheterization of the bile duct permitted balloon dilatation of the ampulla of vater, as well as a duodenal stricture. These maneuvers resulted in passage of the biliary stone and relief of the patient's symptoms. The management of this patient may serve as a guide possibly to delay or even prevent surgical intervention in similar cases of benign enteric strictures.- - - - - - - - - - ranking = 4732.2084701829keywords = bile duct obstruction, duct obstruction, bile duct, bile, obstruction, duct (Clic here for more details about this article) |
6/13. Duodenopancreatic fistula accompanying Crohn's disease of the distal duodenum.A 47-yr-old male with known Crohn's disease involving the third and fourth part of the duodenum and terminal ileum presented to hospital with nausea and vomiting due to duodenal obstruction. An upper gastrointestinal series revealed a clinically unsuspected fistula joining the duodenum and pancreatic duct. He subsequently underwent vagotomy and gastroenterostomy to bypass the obstructed segment of duodenum. The duodenopancreatic fistula was not disturbed. Post-operatively, his symptoms resolved, he gained 30 pounds of weight, and manifested no ill effect secondary to the fistula. A repeat upper gastrointestinal series 9 months postoperatively revealed the fistula to have closed, although marked duodenal narrowing remained.- - - - - - - - - - ranking = 2.6341180810715keywords = obstruction, duct (Clic here for more details about this article) |
7/13. Crohn's disease of the duodenum presented as pancreatitis due to persimmon bezoar.pancreatitis due to Crohn's disease of the duodenum is very rare. It is the result of either reflux of duodenal content into the pancreatic duct or stenosis due to direct involvement of the ampullary region with Crohn's disease. The patient described had isolated Crohn's disease of the duodenum; pancreatitis was the result of persimmon bezoar's constricting the ampullary region.- - - - - - - - - - ranking = 1keywords = duct (Clic here for more details about this article) |
8/13. Obstructive jaundice secondary to nonbiliary extrahepatic inflammatory disease.Two patients with persistent obstructive jaundice secondary to chronic pancreatitis and one patient with this picture secondary to a periduodenal fibrosis are reported. The infrequent occurrence of obstructive jaundice in such inflammatory processes is noted and it is suggested that the presence of a circular muscle coat in the common bile duct protects it from inflammatory narrowing. The need for preoperative anatomic evaluation by radiographic techniques is discussed along with methods of therapy.- - - - - - - - - - ranking = 535.96369295615keywords = extrahepatic, bile duct, bile, duct (Clic here for more details about this article) |
9/13. Duodenal Crohn's disease complicated by common bile duct obstruction: report of a case and review of the literature.A 28-year-old woman with Crohn's disease involving the duodenum and terminal ileum presented with biochemical evidence of incomplete, extrahepatic biliary obstruction. Percutaneous transhepatic cholangiography showed partial obstruction of the intramural duodenal portion of the common bile duct. cholangiography was complicated by cholangitis. Surgical decompression of the biliary system and bypass of the affected duodenal segment were performed after intraoperative confirmation of Crohn's disease involving the ileum, duodenum, and ampulla of vater. The patient made a complete recovery and all previously abnormal cholestatic liver function test results returned to normal.- - - - - - - - - - ranking = 18782.702064309keywords = bile duct obstruction, duct obstruction, extrahepatic, bile duct, bile, obstruction, duct (Clic here for more details about this article) |
10/13. Crohn's disease of the duodenum with spontaneous reflux into the pancreatic duct.A patient with Crohn's disease which involved the duodenum presented with recurrent pancreatitis. His upper gastrointestinal series demonstrated spontaneous reflux of barium into the pancreatic duct. The literature is reviewed and a probable mechanism for this very unusual occurrence is suggested.- - - - - - - - - - ranking = 5keywords = duct (Clic here for more details about this article) |
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