2,157 results on '"Duodenal Diseases diagnosis"'
Search Results
202. Constipation and weight loss in a Honduran immigrant.
- Author
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Ajumobi A, Magulick J, and Wright R
- Subjects
- Animals, Antiparasitic Agents therapeutic use, Biopsy, Duodenal Diseases complications, Duodenal Diseases diagnosis, Duodenal Diseases drug therapy, Endoscopy, Gastrointestinal, Honduras ethnology, Humans, Intestinal Diseases, Parasitic complications, Intestinal Diseases, Parasitic diagnosis, Intestinal Diseases, Parasitic drug therapy, Ivermectin therapeutic use, Male, Middle Aged, Stomach Diseases complications, Stomach Diseases diagnosis, Stomach Diseases drug therapy, Strongyloidiasis complications, Strongyloidiasis diagnosis, Strongyloidiasis drug therapy, Treatment Outcome, United States, Constipation parasitology, Duodenal Diseases parasitology, Emigrants and Immigrants, Intestinal Diseases, Parasitic parasitology, Stomach Diseases parasitology, Strongyloides stercoralis isolation & purification, Strongyloidiasis parasitology, Weight Loss
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- 2015
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203. An unusual cause of bleeding from the duodenum: pyogenic granuloma.
- Author
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van Vliet EP, Arensman R, and Pullens HJ
- Subjects
- Aged, Biopsy, Duodenal Diseases diagnosis, Duodenal Diseases surgery, Duodenoscopy, Gastrointestinal Hemorrhage diagnosis, Granuloma, Pyogenic diagnosis, Granuloma, Pyogenic surgery, Humans, Intestinal Mucosa pathology, Intestinal Mucosa surgery, Male, Treatment Outcome, Duodenal Diseases complications, Gastrointestinal Hemorrhage etiology, Granuloma, Pyogenic complications
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- 2015
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- View/download PDF
204. Purpura in the duodenum.
- Author
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Magalhães-Costa P and Chagas C
- Subjects
- Aged, Anti-Bacterial Agents therapeutic use, Biopsy, Duodenal Diseases diagnosis, Duodenal Diseases drug therapy, Duodenum pathology, Endoscopy, Digestive System, Gastrointestinal Hemorrhage microbiology, Humans, Intestinal Mucosa pathology, Male, Purpura diagnosis, Purpura drug therapy, Treatment Outcome, Tropheryma drug effects, Whipple Disease diagnosis, Whipple Disease drug therapy, Duodenal Diseases microbiology, Duodenum microbiology, Intestinal Mucosa microbiology, Purpura microbiology, Tropheryma isolation & purification, Whipple Disease microbiology
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- 2015
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- View/download PDF
205. Succession of duodenal polypoid lesion.
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Lin HJ, Chang CW, and Chen MJ
- Subjects
- Adult, Biopsy, Choristoma diagnosis, Duodenal Diseases diagnosis, Duodenoscopy, Female, Gastroesophageal Reflux complications, Gastroesophageal Reflux diagnosis, Humans, Intestinal Polyps diagnosis, Choristoma complications, Duodenal Diseases complications, Esomeprazole adverse effects, Gastroesophageal Reflux drug therapy, Intestinal Polyps chemically induced, Proton Pump Inhibitors adverse effects, Stomach
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- 2015
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206. Perils in the playpen: Duodenojejunal fistula in a child following ingestion of two toy magnets.
- Author
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Kisku S, John T, and Mutt N
- Subjects
- Child, Preschool, Duodenal Diseases diagnosis, Duodenal Diseases surgery, Foreign Bodies diagnosis, Foreign Bodies surgery, Humans, Intestinal Fistula diagnosis, Intestinal Fistula surgery, Jejunal Diseases diagnosis, Jejunal Diseases surgery, Male, Duodenal Diseases etiology, Foreign Bodies etiology, Intestinal Fistula etiology, Jejunal Diseases etiology, Magnets, Play and Playthings
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- 2015
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207. Duodenal Leishmaniasis Mimicking Celiac Disease.
- Author
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Ahuja A and Bhardwaj M
- Subjects
- Adult, Diagnosis, Differential, Female, Humans, Celiac Disease diagnosis, Duodenal Diseases diagnosis, Duodenal Diseases therapy, Leishmaniasis diagnosis, Leishmaniasis therapy
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- 2015
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208. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.
- Author
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Pennazio M, Spada C, Eliakim R, Keuchel M, May A, Mulder CJ, Rondonotti E, Adler SN, Albert J, Baltes P, Barbaro F, Cellier C, Charton JP, Delvaux M, Despott EJ, Domagk D, Klein A, McAlindon M, Rosa B, Rowse G, Sanders DS, Saurin JC, Sidhu R, Dumonceau JM, Hassan C, and Gralnek IM
- Subjects
- Adenomatous Polyposis Coli diagnosis, Anemia, Iron-Deficiency etiology, Celiac Disease diagnosis, Crohn Disease diagnosis, Duodenal Diseases complications, Duodenal Diseases therapy, Gastrointestinal Hemorrhage diagnosis, Humans, Ileal Diseases complications, Ileal Diseases therapy, Intestinal Neoplasms complications, Jejunal Diseases complications, Jejunal Diseases therapy, Peutz-Jeghers Syndrome diagnosis, Capsule Endoscopy, Double-Balloon Enteroscopy, Duodenal Diseases diagnosis, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage therapy, Ileal Diseases diagnosis, Intestinal Neoplasms diagnosis, Jejunal Diseases diagnosis, Population Surveillance methods
- Abstract
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). The Guideline was also reviewed and endorsed by the British Society of Gastroenterology (BSG). It addresses the roles of small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders. Main recommendations 1 ESGE recommends small-bowel video capsule endoscopy as the first-line investigation in patients with obscure gastrointestinal bleeding (strong recommendation, moderate quality evidence). 2 In patients with overt obscure gastrointestinal bleeding, ESGE recommends performing small-bowel capsule endoscopy as soon as possible after the bleeding episode, optimally within 14 days, in order to maximize the diagnostic yield (strong recommendation, moderate quality evidence). 3 ESGE does not recommend the routine performance of second-look endoscopy prior to small-bowel capsule endoscopy; however whether to perform second-look endoscopy before capsule endoscopy in patients with obscure gastrointestinal bleeding or iron-deficiency anaemia should be decided on a case-by-case basis (strong recommendation, low quality evidence). 4 In patients with positive findings at small-bowel capsule endoscopy, ESGE recommends device-assisted enteroscopy to confirm and possibly treat lesions identified by capsule endoscopy (strong recommendation, high quality evidence). 5 ESGE recommends ileocolonoscopy as the first endoscopic examination for investigating patients with suspected Crohn's disease (strong recommendation, high quality evidence). In patients with suspected Crohn's disease and negative ileocolonoscopy findings, ESGE recommends small-bowel capsule endoscopy as the initial diagnostic modality for investigating the small bowel, in the absence of obstructive symptoms or known stenosis (strong recommendation, moderate quality evidence).ESGE does not recommend routine small-bowel imaging or the use of the PillCam patency capsule prior to capsule endoscopy in these patients (strong recommendation, low quality evidence). In the presence of obstructive symptoms or known stenosis, ESGE recommends that dedicated small bowel cross-sectional imaging modalities such as magnetic resonance enterography/enteroclysis or computed tomography enterography/enteroclysis should be used first (strong recommendation, low quality evidence). 6 In patients with established Crohn's disease, based on ileocolonoscopy findings, ESGE recommends dedicated cross-sectional imaging for small-bowel evaluation since this has the potential to assess extent and location of any Crohn's disease lesions, to identify strictures, and to assess for extraluminal disease (strong recommendation, low quality evidence). In patients with unremarkable or nondiagnostic findings from such cross-sectional imaging of the small bowel, ESGE recommends small-bowel capsule endoscopy as a subsequent investigation, if deemed to influence patient management (strong recommendation, low quality evidence). When capsule endoscopy is indicated, ESGE recommends use of the PillCam patency capsule to confirm functional patency of the small bowel (strong recommendation, low quality evidence). 7 ESGE strongly recommends against the use of small-bowel capsule endoscopy for suspected coeliac disease but suggests that capsule endoscopy could be used in patients unwilling or unable to undergo conventional endoscopy (strong recommendation, low quality evidence)., (© Georg Thieme Verlag KG Stuttgart · New York.)
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- 2015
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209. Repair of aortoenteric fistula secondary to graft placement for middle aortic syndrome.
- Author
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Zheng H, Troutman DA, Dougherty MJ, and Calligaro KD
- Subjects
- Adult, Aortic Diseases diagnosis, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation instrumentation, Duodenal Diseases diagnosis, Duodenal Diseases etiology, Humans, Intestinal Fistula diagnosis, Intestinal Fistula etiology, Male, Prosthesis Design, Reoperation, Surgical Flaps, Time Factors, Treatment Outcome, Vascular Fistula diagnosis, Vascular Fistula etiology, Aortic Diseases surgery, Blood Vessel Prosthesis Implantation adverse effects, Device Removal, Duodenal Diseases surgery, Intestinal Fistula surgery, Vascular Fistula surgery
- Abstract
When an aortoenteric fistula (AEF) arises secondary to suprarenal or more proximal aortic repair, mortality and the complexity of the surgery increases. We present the first reported case to our knowledge of a secondary AEF arising 13 years after surgical repair of middle aortic syndrome. We performed the original surgery on a 22-year-old male who presented with hypertension and claudication by placing a Dacron prosthetic patch on the juxtarenal and infrarenal aorta, bilateral vein bypasses to the left and right renal artery, and a Dacron bypass to the proximal superior mesenteric artery. Thirteen years later, he presented with massive gastrointestinal bleeding and syncope. We performed a distal descending thoracic aortic rifampin-soaked bifurcated Dacron graft to the left renal artery and to a large meandering mesenteric artery followed by excision of all previous prosthetic graft and insertion of a rifampin-soaked tube graft from the distal descending thoracic aorta to the distal abdominal aorta with omental flap coverage. After a complicated postoperative course, he was discharged 2 months later and remains on dialysis at his 6-month postoperative follow-up without evidence of recurrent infection., (Copyright © 2015 Elsevier Inc. All rights reserved.)
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- 2015
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210. Hereditary angioedema involving the duodenum. An unusual cause of upper abdominal pain.
- Author
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Robert B
- Subjects
- Abdominal Pain diagnosis, Angioedemas, Hereditary diagnosis, Duodenal Diseases diagnosis, Female, Humans, Young Adult, Abdominal Pain etiology, Angioedemas, Hereditary complications, Duodenal Diseases complications
- Published
- 2015
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211. [Pancreatic heterotopia as an unusual cause of upper gastrointestinal bleeding].
- Author
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Boufettal R, Elbakouri A, Jai SR, and Chehab F
- Subjects
- Female, Humans, Middle Aged, Choristoma complications, Choristoma diagnosis, Duodenal Diseases complications, Duodenal Diseases diagnosis, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage etiology, Pancreas
- Published
- 2015
- Full Text
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212. Duodenal cryptococcus infection in an AIDS patient: retrospective clinical analysis.
- Author
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Li J, Wang N, Hong Q, Bai C, Hu B, and Tan Y
- Subjects
- Aged, Humans, Male, Multimodal Imaging methods, Positron-Emission Tomography, Retrospective Studies, Tomography, X-Ray Computed, AIDS-Related Opportunistic Infections diagnosis, Cryptococcosis diagnosis, Cryptococcus neoformans, Duodenal Diseases diagnosis
- Abstract
Cryptococcal infection primarily affects the lung or the central nervous system and rare cases have been reported involving the gastrointestinal tract. However, among patients with HIV/AIDS, the gastrointestinal involvement is increasing. According to the PubMed search results, there were seven cases reported involving duodenal cryptococcosis combined with AIDS in five reports. Here, we report the case of a patient found to have AIDS combined with duodenal, pulmonary, and subsequent neurological cryptococcal infection simultaneously. The duodenal cryptococcosis was diagnosed on the basis of PET/computed tomography, which showed intense captation of glucose metabolism in duodenum (maximum standardized uptake value 16.53); a positive serum cryptococcal latex agglutination test; and upper gastrointestinal endoscopy-guided duodenal biopsy that confirmed Cryptococcus neoformans yeast. The patient's HIV screen test was positive. Because of refusal of lumbar puncture and the difficulty of performing transbronchial lung biopsy, the pulmonary and neurological involvements were the only clinical diagnoses. This case indicates that when cryptococcosis exists in a rare location, AIDS should be considered and when cryptococcosis occurs in the HIV-infected patient, disseminated disease is more common.
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- 2015
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213. Gastroduodenal intussusception due to gastric schwannoma treated by Billroth II distal gastrectomy: one case report.
- Author
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Yang JH, Zhang M, Zhao ZH, Shu Y, Hong J, and Cao YJ
- Subjects
- Aged, Biomarkers, Tumor analysis, Biopsy, Colic etiology, Duodenal Diseases diagnosis, Duodenal Diseases etiology, Humans, Immunohistochemistry, Intussusception diagnosis, Intussusception etiology, Male, Neurilemmoma chemistry, Neurilemmoma complications, Neurilemmoma pathology, S100 Proteins analysis, Stomach Neoplasms chemistry, Stomach Neoplasms complications, Stomach Neoplasms pathology, Tomography, X-Ray Computed, Treatment Outcome, Duodenal Diseases surgery, Gastrectomy methods, Gastroenterostomy methods, Intussusception surgery, Neurilemmoma surgery, Stomach Neoplasms surgery
- Abstract
Schwannomas are rarely observed in the gastrointestinal tract. The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia, gastrointestinal bleeding, and an abdominal mass. Many gastric schwannomas are asymptomatic and are discovered incidentally or at postmortem. The diagnosis of a schwannoma is based on immunohistochemical positivity for S-100 protein. We present a case report of a rare complication of gastric schwannoma causing gastroduodenal intussusception that was successfully managed by a Billroth II distal gastrectomy. In this rare case, the patient had intermittent, colicky abdominal pain, nausea, and vomiting for over 4 wk accompanied by a weight loss. A diagnosis of gastric intussusception was made by computed tomography. A Billroth II distal gastrectomy was then performed, and complete en bloc removal (R0 resection) was achieved. Pathology confirmed a gastric schwannoma through positive immunohistochemical staining for S-100 protein.
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- 2015
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214. Primary duodenal carcinoma--case report.
- Author
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Wesecki M, Niemiec S, Radziuk D, Waniczek D, and Lorenc Z
- Subjects
- Adenocarcinoma complications, Anastomosis, Surgical, Duodenal Diseases complications, Duodenal Diseases diagnosis, Duodenal Diseases surgery, Duodenal Neoplasms complications, Duodenum surgery, Female, Humans, Intestinal Fistula complications, Middle Aged, Treatment Outcome, Adenocarcinoma diagnosis, Adenocarcinoma surgery, Duodenal Neoplasms diagnosis, Duodenal Neoplasms surgery, Intestinal Fistula diagnosis, Intestinal Fistula surgery
- Abstract
Duodenal carcinoma is a rare tumor of the gastrointestinal tract of an insidious and secretive course, often diagnosed during the advanced stage of the disease. The study presented a case of a female patient diagnosed with duodenal carcinoma, subjected to two-staged surgery. The initial surgical intervention consisted in the implementation of a gastrointestinal anastomosis, followed by radical surgery by means of Whipple's method performed after three years.
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- 2015
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215. Evaluation of the effectiveness of methods of endoscopic treatment of bleeding from the duodenal mucosa.
- Author
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Frątczak A, Kujawski K, Gluba-Brzózka A, and Rysz J
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Duodenal Diseases diagnosis, Epinephrine administration & dosage, Female, Gastrointestinal Hemorrhage diagnosis, Humans, Injections, Male, Middle Aged, Retrospective Studies, Surgical Instruments, Treatment Outcome, Young Adult, Duodenal Diseases therapy, Gastrointestinal Hemorrhage therapy, Hemostasis, Endoscopic methods
- Abstract
Unlabelled: Bleeding from the upper gastrointestinal tract, despite the prevalence of endoscopic examinations and endoscopic methods of bleeding control, remains a significant problem. Available data indicate nondecreasing mortality of patients with active bleeding from the upper gastrointestinal tract although it is commonly known that such patients require fast endoscopic diagnosis and urgent treatment. Currently, the choice of method of endoscopic treatment of bleeding depends mostly on its availability and the decision of the physician performing the procedure., Aim: The aim of the study was to evaluate the efficacy of different techniques of endoscopic hemostasis from the duodenum, mainly the comparison of monotherapy with the use of at least two techniques of endoscopic treatment of bleeding used simultaneously., Materials and Methods: This paper presents a retrospective analysis of medical records of 78 patients (27 women, 51 men; 33 of them were over 65 years), hospitalized in the Department of Nephrology, Hypertension and Family Medicine between 2009 and 2012. In all these patients, active bleeding from the duodenum was observed during endoscopy performed because of clinical signs of gastrointestinal bleeding, and the following methods of blood flow stemming were applied: injection with a solution of adrenaline alone or in combination with placement of clips., Results: The use of haemostatic clips alone or in a combination with injections of adrenaline around the bleeding site was demonstrated to be the most effective method of endoscopic control of bleeding from the duodenum. Injections of epinephrine around the bleeding site as monotherapy turned out to be the least effective method., Conclusions: The most effective method of endoscopic control of bleeding from duodenal ulcers is the use of hemostatic clips alone or preceded by adrenaline injections, while the use of injections of adrenaline around the bleeding vessel was the least effective method., (© 2015 MEDPRESS.)
- Published
- 2015
216. What are these yellow deposits in the duodenum?
- Author
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Abe K, Koga I, and Hoshimoto K
- Subjects
- Adult, Humans, Male, Nontuberculous Mycobacteria isolation & purification, Duodenal Diseases diagnosis, Mycobacterium Infections, Nontuberculous diagnosis
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- 2015
- Full Text
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217. Pseudomelanosis of stomach, duodenum, and jejunum.
- Author
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Rustagi T, Mansoor MS, Gibson JA, and Kapadia CR
- Subjects
- Aged, Biomarkers analysis, Biopsy, Duodenal Diseases metabolism, Duodenal Diseases pathology, Duodenum chemistry, Endoscopy, Gastrointestinal, Female, Gastric Mucosa chemistry, Humans, Intestinal Mucosa chemistry, Jejunal Diseases complications, Jejunal Diseases metabolism, Jejunal Diseases pathology, Jejunum chemistry, Melanosis metabolism, Melanosis pathology, Pigments, Biological analysis, Predictive Value of Tests, Stomach Diseases metabolism, Stomach Diseases pathology, Duodenal Diseases diagnosis, Jejunal Diseases diagnosis, Melanosis diagnosis, Stomach Diseases diagnosis
- Abstract
Pseudomelanosis is a rare finding during upper gastrointestinal endoscopy, and is most commonly seen in the duodenum. Involvement of other organs in the upper gastrointestinal tract is extremely rare, with only 1 reported case involving the stomach, duodenum, and jejunum. We present a case of a 60-year-old woman with mild anemia and hematemesis, who was found to have characteristic speckled pattern of gray-black pigmentation on endoscopic examination. To the best of our knowledge, this is the second reported case of pseudomelanosis involving the stomach, duodenum, and jejunum.
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- 2015
- Full Text
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218. Acute pancreatitis with an intramural duodenal hematoma.
- Author
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Chang CM, Huang HH, and How CK
- Subjects
- Abdominal Pain etiology, Adult, Duodenum diagnostic imaging, Duodenum pathology, Humans, Intestinal Mucosa pathology, Male, Tomography, X-Ray Computed, Vomiting etiology, Duodenal Diseases complications, Duodenal Diseases diagnosis, Gastrointestinal Hemorrhage complications, Hematoma complications, Hematoma diagnosis, Pancreatitis complications, Pancreatitis diagnosis
- Abstract
The patient was a 43-year-old man admitted to the hospital with intermittent epigastric pain and vomiting, without any evidence of trauma. Blood tests showed elevated lipase/amylase levels. Abdominal computed tomography (CT) revealed pancreatitis complicated by an intramural duodenal hematoma (IDH). He was conservatively treated, and one month after admission, follow-up panendoscopy showed normal duodenal mucosa without luminal narrowing. Non-traumatic IDH is typically associated with coagulation abnormalities. Abdominal CT is an excellent tool for diagnosis in cases of acute abdomen. However, the pathogenesis of and relationship between IDH and pancreatitis remain unknown.
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- 2015
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219. Olmesartan-induced enteropathy.
- Author
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Heerasing N, Hair C, and Wallace S
- Subjects
- Aged, Angiotensin II Type 1 Receptor Blockers administration & dosage, Angiotensin II Type 1 Receptor Blockers adverse effects, Dose-Response Relationship, Drug, Duodenal Diseases diagnosis, Duodenoscopy, Duodenum drug effects, Female, Follow-Up Studies, Humans, Hypertension drug therapy, Imidazoles therapeutic use, Olmesartan Medoxomil, Tetrazoles therapeutic use, Duodenal Diseases chemically induced, Duodenum pathology, Imidazoles adverse effects, Tetrazoles adverse effects
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- 2015
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220. Quality indicators for EGD.
- Author
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Park WG, Shaheen NJ, Cohen J, Pike IM, Adler DG, Inadomi JM, Laine LA, Lieb JG 2nd, Rizk MK, Sawhney MS, and Wani S
- Subjects
- Advisory Committees, Biopsy, Duodenal Diseases pathology, Duodenal Diseases surgery, Esophageal Diseases pathology, Esophageal Diseases surgery, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage pathology, Gastrointestinal Hemorrhage surgery, Humans, Informed Consent, Stomach Diseases pathology, Stomach Diseases surgery, Duodenal Diseases diagnosis, Endoscopy, Digestive System standards, Esophageal Diseases diagnosis, Quality Indicators, Health Care, Stomach Diseases diagnosis
- Published
- 2015
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221. [THE COMBINATION OF RECURRENT INTUSSUSCEPTION DUODENAL, ZENKER DIVERTICULUM, HIATAL HERNIA AND HASTROPTOSIS AS A MANIFESTATION OF NON-DIFFERENT DYSPLASIA OF CONNECTIVE TISSUE].
- Author
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Pavlov MV and Orlova NV
- Subjects
- Aged, Connective Tissue diagnostic imaging, Duodenal Diseases complications, Duodenal Diseases diagnostic imaging, Endoscopy, Digestive System, Female, Hernia, Hiatal complications, Hernia, Hiatal diagnostic imaging, Humans, Intussusception complications, Intussusception diagnostic imaging, Radiography, Zenker Diverticulum complications, Zenker Diverticulum diagnostic imaging, Connective Tissue pathology, Duodenal Diseases diagnosis, Hernia, Hiatal diagnosis, Intussusception diagnosis, Zenker Diverticulum diagnosis
- Abstract
Presented rare clinical case: a combination of recurrent intussusception duodenal, diverticulum Zenker, hiatal hernia and hastroptosis as a manifestation of non-different dysplasia of connective tissue. Special interest is recurrent intussusception upper horizontal portion duodenal in the bulb, is not detected when esophagogastroduodenoscopy.
- Published
- 2015
222. Endoscopic treatment of a duodenal invagination.
- Author
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Miranda-García P, Tellechea JI, Gonzalez JM, Culetto A, and Barthet M
- Subjects
- Duodenal Diseases diagnosis, Endoscopy, Gastrointestinal instrumentation, Humans, Intussusception diagnosis, Male, Middle Aged, Stents, Duodenal Diseases surgery, Endoscopy, Gastrointestinal methods, Intussusception surgery
- Published
- 2015
- Full Text
- View/download PDF
223. Gastrointestinal strongyloidiasis.
- Author
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Chen CJ, Tsai JW, and Tai CM
- Subjects
- Colonic Diseases parasitology, Colonoscopy, Duodenal Diseases parasitology, Endoscopy, Digestive System, Female, Humans, Middle Aged, Colonic Diseases diagnosis, Duodenal Diseases diagnosis, Intestinal Diseases, Parasitic diagnosis, Strongyloidiasis diagnosis
- Published
- 2015
- Full Text
- View/download PDF
224. Primary aortoenteric fistula: case report.
- Author
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Costea R, Vasiliu EC, Zărnescu NO, and Neagu S
- Subjects
- Abdominal Pain etiology, Aged, 80 and over, Aortic Dissection diagnosis, Aortic Dissection therapy, Aortic Aneurysm, Abdominal diagnosis, Aortic Aneurysm, Abdominal therapy, Duodenal Diseases diagnosis, Duodenal Diseases therapy, Fatal Outcome, Female, Gastrointestinal Hemorrhage etiology, Hematemesis etiology, Humans, Intestinal Fistula diagnosis, Intestinal Fistula therapy, Vascular Fistula diagnosis, Vascular Fistula therapy, Aortic Dissection complications, Aortic Aneurysm, Abdominal complications, Aortic Rupture, Duodenal Diseases complications, Intestinal Fistula etiology, Vascular Fistula etiology
- Abstract
We report the case of an elderly woman, 81 years old, who was admitted in our department for hematemesis, hematochezia and lower abdominal pain. The abdominal ultrasound and the CT scan diagnosed a primary aortoenteric fistula between an abdominal aortic aneurysm (AAA) and the second part of the duodenum, which is a very rare localization regarding this condition. Surgical pathology,diagnosis and management are discussed., (Celsius.)
- Published
- 2015
225. Duodenal hematoma following EGD: comparison with blunt abdominal trauma-induced duodenal hematoma.
- Author
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Sahn B, Anupindi SA, Dadhania NJ, Kelsen JR, Nance ML, and Mamula P
- Subjects
- Adolescent, Biopsy adverse effects, Child, Child, Preschool, Cohort Studies, Cross-Sectional Studies, Duodenal Diseases diagnosis, Duodenal Diseases etiology, Duodenal Diseases pathology, Duodenum injuries, Duodenum pathology, Female, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage pathology, Hematoma diagnosis, Hematoma etiology, Hematoma pathology, Hospitals, Pediatric, Humans, Incidence, Infant, Intestinal Mucosa injuries, Intestinal Mucosa pathology, Male, Philadelphia epidemiology, Postoperative Hemorrhage diagnosis, Postoperative Hemorrhage etiology, Postoperative Hemorrhage pathology, Retrospective Studies, Risk Factors, Wounds, Nonpenetrating diagnosis, Wounds, Nonpenetrating pathology, Wounds, Nonpenetrating physiopathology, Duodenal Diseases epidemiology, Endoscopy, Digestive System adverse effects, Gastrointestinal Hemorrhage epidemiology, Hematoma epidemiology, Postoperative Hemorrhage epidemiology
- Abstract
Background: Duodenal hematoma (DH) is a rare complication of esophagogastroduodenoscopy (EGD) with duodenal biopsy and uncommon, but better described following blunt abdominal trauma (BAT). We aimed to describe DH incidence and investigate risk factors for DH development post-EGD and compare its features to those post-BAT., Methods: Multiple electronic databases were searched for the diagnosis of DH from 2000 to 2012. Inclusion criteria were patients 0 to 21 years of age who developed a DH following EGD with biopsy or BAT. Exclusion criteria were DH secondary to any other mechanism, EGD performed at another medical center, and insufficient information in the electronic medical record to determine treatments or outcomes., Results: A total of 14 post-EGD and 15 post-BAT patients with DH were included in the study. There were 26,905 EGDs with duodenal biopsies performed during the study period, for an incidence of 1:1922 procedures. Thirteen of 14 (93%) post-EGD DH events occurred between 2007 and 2012 (P < 0.001). The proportion of procedures performed under general anesthesia versus moderate sedation, and performed in the supine position versus left lateral decubitus were close to but did not reach statistical significance. DH-related complications and time to hematoma resolution was similar between groups., Conclusions: In a 13-year study period, 14 patients developed DH after EGD, for an incidence of 1:1922. Method of sedation and supine positioning of the patient during endoscopy warrant further investigation as potential risks. The clinical course and time to recovery with conservative management are similar between patients with EGD and BAT-induced DH.
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- 2015
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226. Gastric outlet obstruction caused by intramural duodenal pseudocysts in a young man with acute pancreatitis.
- Author
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Choudhary NS, Puri R, and Sud R
- Subjects
- Adult, Cysts etiology, Duodenal Diseases etiology, Endosonography, Gastroscopy, Humans, Male, Pancreatitis diagnosis, Cysts diagnosis, Duodenal Diseases diagnosis, Gastric Outlet Obstruction etiology, Pancreatitis complications
- Published
- 2015
- Full Text
- View/download PDF
227. Multimodality imaging of diseases of the duodenum.
- Author
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McNeeley MF, Lalwani N, Dhakshina Moorthy G, Maki J, Dighe MK, Lehnert B, and Prasad SR
- Subjects
- Adult, Cholangiopancreatography, Magnetic Resonance methods, Contrast Media, Duodenum diagnostic imaging, Duodenum pathology, Female, Fluoroscopy methods, Humans, Image Enhancement methods, Male, Middle Aged, Young Adult, Duodenal Diseases diagnosis, Magnetic Resonance Imaging methods, Multimodal Imaging methods, Tomography, X-Ray Computed methods
- Abstract
The duodenum is a unique segment of intestine, occupying both intra and extra-peritoneal locations. There is a wide spectrum of abnormalities of the duodenum that range from congenital anomalies to traumatic, inflammatory, and neoplastic entities. The duodenum may be overlooked on cross-sectional imaging due to its location and small size. Duodenal pathologies may, therefore, be missed or wrongly diagnosed. Knowledge about duodenal pathologies and optimal imaging techniques can increase diagnostic yield and permit optimal patient management. Conventionally, the duodenum was evaluated with upper GI studies on fluoroscopy; however, endoluminal evaluation is better performed with endoscopy. Additionally, a broad array of cross-sectional imaging modalities permits comprehensive assessment of the duodenum and surrounding viscera. While endoscopic sonography is increasingly used to locally stage duodenal malignancies, MDCT remains the primary modality widely used in the detection and characterization of duodenal abnormalities. MRI is used as a "problem solving" modality in select conditions. We present a comprehensive review of duodenal abnormalities with an emphasis on accurate diagnosis and management.
- Published
- 2014
- Full Text
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228. Upper GI bleeding.
- Author
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Gralnek IM
- Subjects
- Acute Disease, Duodenal Diseases diagnosis, Esophageal and Gastric Varices diagnosis, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage epidemiology, Gastrointestinal Hemorrhage etiology, Humans, Stomach Diseases diagnosis, Duodenal Diseases therapy, Esophageal and Gastric Varices therapy, Gastrointestinal Hemorrhage therapy, Stomach Diseases therapy
- Published
- 2014
- Full Text
- View/download PDF
229. Malignant duodenocolic fistula diagnosed by endoscopy.
- Author
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Gülşen MT
- Subjects
- Adenocarcinoma complications, Aged, Colonic Neoplasms complications, Duodenal Diseases etiology, Endoscopy, Gastrointestinal, Fatal Outcome, Humans, Intestinal Fistula etiology, Male, Adenocarcinoma diagnosis, Colonic Neoplasms diagnosis, Duodenal Diseases diagnosis, Intestinal Fistula diagnosis
- Published
- 2014
- Full Text
- View/download PDF
230. Clinics in diagnostic imaging. 158. Duodenal ectopic pancreas.
- Author
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Subramanian M, Wee E, Desai V, and Peh WC
- Subjects
- Accidents, Traffic, Choristoma congenital, Choristoma surgery, Contrast Media, Duodenal Diseases congenital, Duodenal Diseases surgery, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Humans, Male, Middle Aged, Tomography, X-Ray Computed methods, Choristoma diagnosis, Duodenal Diseases diagnosis, Pancreas
- Abstract
A 46-year-old man presented with right loin tenderness following a road traffic accident. Computed tomography and magnetic resonance imaging showed a well-defined, smooth, enhancing oval lesion in the wall of the first part of the duodenum. The lesion was seen separately from the normal pancreas. It showed attenuation, intensity and enhancement similar to that of normal pancreas. Based on the imaging appearance, a diagnosis of ectopic pancreas was made. The patient underwent oesophagogastroduodenoscopy, endoscopic ultrasonography and fine-needle aspiration cytology of the lesion, which confirmed ectopic pancreatic tissue. Since the patient was asymptomatic, surgical resection was deferred. The embryologic origin, various locations, imaging appearance and clinical significance of ectopic pancreas are discussed.
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- 2014
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231. Epidemiology and diagnosis of acute nonvariceal upper gastrointestinal bleeding.
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Rotondano G
- Subjects
- Acute Disease, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Aspirin administration & dosage, Aspirin adverse effects, Duodenal Diseases epidemiology, Esophageal Diseases epidemiology, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage mortality, Helicobacter Infections epidemiology, Helicobacter pylori, Humans, Incidence, Platelet Aggregation Inhibitors adverse effects, Risk Factors, Stomach Diseases epidemiology, Time Factors, Duodenal Diseases diagnosis, Endoscopy, Gastrointestinal, Esophageal Diseases diagnosis, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage epidemiology, Stomach Diseases diagnosis
- Abstract
Acute upper gastrointestinal bleeding (UGIB) is a common gastroenterological emergency. A vast majority of these bleeds have nonvariceal causes, in particular gastroduodenal peptic ulcers. Nonsteroidal antiinflammatory drugs, low-dose aspirin use, and Helicobacter pylori infection are the main risk factors for UGIB. Current epidemiologic data suggest that patients most affected are older with medical comorbidit. Widespread use of potentially gastroerosive medications underscores the importance of adopting gastroprotective pharamacologic strategies. Endoscopy is the mainstay for diagnosis and treatment of acute UGIB. It should be performed within 24 hours of presentation by skilled operators in adequately equipped settings, using a multidisciplinary team approach., (Copyright © 2014 Elsevier Inc. All rights reserved.)
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- 2014
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232. Decrease of serum level of gastrin in healthy Japanese adults by the change of Helicobacter pylori infection.
- Author
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Shimoyama T, Chinda D, Matsuzaka M, Takahashi I, Nakaji S, and Fukuda S
- Subjects
- Adult, Aged, Aged, 80 and over, Asian People, Biomarkers blood, Disease Eradication statistics & numerical data, Duodenal Diseases diagnosis, Gastritis prevention & control, Humans, Japan epidemiology, Male, Middle Aged, Prevalence, Reference Values, Stomach Diseases diagnosis, Gastrins blood, Gastritis epidemiology, Gastritis microbiology, Helicobacter Infections, Helicobacter pylori
- Abstract
Background and Aim: In Japan, the prevalence of Helicobacter pylori infection is decreasing and the number of patients who receive eradication therapy is increasing. Although the serum level of gastrin is affected by H. pylori infection, the normal level has been unchanged for more than 20 years. The aim of this study was to study whether the present normal range for the serum gastrin level is appropriate for Japanese at present or in the near future., Methods: We studied 810 adults (40-80 years old) who participated in a health survey in 2012. We measured H. pylori stool antigen, titer of serum antibody to H. pylori, and serum level of gastrin. The patient's H. pylori status was defined as positive or negative when the results of both stool antigen and serology were concordant. Subjects who were taking proton-pump inhibitor and had a previous history of gastric surgery were excluded., Results: Mean serum level of gastrin was 66.2±49.6 pg/mL in 281 H. pylori-negative subjects and 69.7±42.2 pg/mL in 115 patients who had H. pylori eradicated at least 2 years ago. The level of gastrin was 134.4±145.6 pg/mL in 224 patients with H. pylori infection and the level was significantly higher when compared with those in uninfected subjects and eradicated patients (P<0.01)., Conclusions: Because the situation of H. pylori infection has changed remarkably in Japan, a new appropriate normal range of gastrin should be established using current Japanese populations., (© 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.)
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- 2014
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233. Aortoduodenal syndrome in a patient receiving maintenance haemodialysis.
- Author
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Saigusa S, Ohi M, Imaoka H, and Inoue Y
- Subjects
- Aged, 80 and over, Aortic Aneurysm, Abdominal diagnostic imaging, Diagnosis, Differential, Duodenal Diseases diagnosis, Duodenal Diseases diagnostic imaging, Humans, Imaging, Three-Dimensional, Intestinal Obstruction diagnosis, Intestinal Obstruction diagnostic imaging, Male, Radiography, Superior Mesenteric Artery Syndrome diagnosis, Syndrome, Aortic Aneurysm, Abdominal complications, Duodenal Diseases etiology, Intestinal Obstruction etiology, Renal Dialysis
- Abstract
An 83-year-old man receiving maintenance haemodialysis presented with abdominal pain, fever and emesis. He was initially diagnosed with acute cholecystitis. His pain and fever improved with fasting and antibiotics, but he continued to suffer from anorexia and emesis. Enhanced abdominal CT scan showed evidence of superior mesenteric artery (SMA) syndrome versus obstruction of the third part of the duodenum caused by abdominal aortic aneurysm (AAA), the so-called aortoduodenal syndrome. An upper gastrointestinal contrast study revealed duodenal dilation and blockage of the third part of the duodenum. The AAA continued to enlarge over the subsequent 3 months and the intra-abdominal visceral fat volume decreased over 1 month. The aortomesentric angle and distance remained within normal ranges. Ultimately, the patient was diagnosed with aortoduodenal syndrome. In the present case, a duodenal obstruction was caused by the combination of an enlarged AAA and reduced intra-abdominal visceral fat in a patient receiving maintenance haemodialysis., (2014 BMJ Publishing Group Ltd.)
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- 2014
- Full Text
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234. Stomach and duodenum.
- Author
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Schubert ML
- Subjects
- Anticoagulants adverse effects, Duodenal Diseases diagnosis, Duodenal Diseases immunology, Gastric Mucosa immunology, Helicobacter Infections diagnosis, Helicobacter Infections immunology, Helicobacter Infections therapy, Humans, Stomach Diseases diagnosis, Stomach Diseases immunology, Duodenal Diseases therapy, Gastric Mucosa physiopathology, Gastrointestinal Hemorrhage chemically induced, Heart Diseases drug therapy, Stomach Diseases therapy
- Published
- 2014
- Full Text
- View/download PDF
235. Automatic lesion detection in capsule endoscopy based on color saliency: closer to an essential adjunct for reviewing software.
- Author
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Iakovidis DK and Koulaouzidis A
- Subjects
- Case-Control Studies, Electronic Data Processing, Gastrointestinal Hemorrhage diagnosis, Humans, Image Processing, Computer-Assisted, Intestinal Polyps diagnosis, Lymphangiectasis, Intestinal diagnosis, Peptic Ulcer diagnosis, ROC Curve, Reproducibility of Results, Stomatitis, Aphthous diagnosis, Capsule Endoscopy methods, Color, Diagnosis, Computer-Assisted, Duodenal Diseases diagnosis, Ileal Diseases diagnosis, Jejunal Diseases diagnosis, Pattern Recognition, Automated, Software
- Abstract
Background: The advent of wireless capsule endoscopy (WCE) has revolutionized the diagnostic approach to small-bowel disease. However, the task of reviewing WCE video sequences is laborious and time-consuming; software tools offering automated video analysis would enable a timelier and potentially a more accurate diagnosis., Objective: To assess the validity of innovative, automatic lesion-detection software in WCE., Design/intervention: A color feature-based pattern recognition methodology was devised and applied to the aforementioned image group., Setting: This study was performed at the Royal Infirmary of Edinburgh, United Kingdom, and the Technological Educational Institute of Central Greece, Lamia, Greece., Materials: A total of 137 deidentified WCE single images, 77 showing pathology and 60 normal images., Results: The proposed methodology, unlike state-of-the-art approaches, is capable of detecting several different types of lesions. The average performance, in terms of the area under the receiver-operating characteristic curve, reached 89.2 ± 0.9%. The best average performance was obtained for angiectasias (97.5 ± 2.4%) and nodular lymphangiectasias (96.3 ± 3.6%)., Limitations: Single expert for annotation of pathologies, single type of WCE model, use of single images instead of entire WCE videos., Conclusion: A simple, yet effective, approach allowing automatic detection of all types of abnormalities in capsule endoscopy is presented. Based on color pattern recognition, it outperforms previous state-of-the-art approaches. Moreover, it is robust in the presence of luminal contents and is capable of detecting even very small lesions., (Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.)
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- 2014
- Full Text
- View/download PDF
236. Duodenal diverticula: potential complications and common imaging pitfalls.
- Author
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Schroeder TC, Hartman M, Heller M, Klepchick P, and Ilkhanipour K
- Subjects
- Abdominal Pain etiology, Aged, Cholangiopancreatography, Magnetic Resonance methods, Diverticulitis etiology, Duodenum anatomy & histology, Duodenum diagnostic imaging, Duodenum pathology, Female, Humans, Magnetic Resonance Imaging methods, Male, Middle Aged, Tomography, X-Ray Computed methods, Diagnostic Imaging methods, Diverticulum complications, Diverticulum diagnosis, Duodenal Diseases complications, Duodenal Diseases diagnosis
- Abstract
A duodenal diverticulum is a commonly encountered entity in gastrointestinal radiology with a wide variety of appearances. The purpose of this review is to describe the normal anatomy and embryology of the duodenum, discuss the differences between a true versus intraluminal duodenal diverticulum, and to highlight the normal appearance, potential complications, and imaging pitfalls of duodenal diverticula., (Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2014
- Full Text
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237. The clinical importance of different localizations of the papilla associated with juxtapapillary duodenal diverticula.
- Author
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Ozogul B, Ozturk G, Kisaoglu A, Aydinli B, Yildirgan M, and Atamanalp SS
- Subjects
- Adult, Aged, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, Cholelithiasis complications, Cholelithiasis surgery, Diagnosis, Differential, Diverticulum surgery, Duodenal Diseases complications, Duodenal Diseases surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Ampulla of Vater surgery, Cholelithiasis diagnosis, Diverticulum diagnosis, Duodenal Diseases diagnosis, Sphincterotomy, Endoscopic methods
- Abstract
Background: Previous studies have evaluated the presence of juxtapapillary duodenal diverticula (JPDD) and the association with pancreatobiliary disease, but not the association of the papilla with an existing JPDD. We investigated the association of different localizations of the papilla with JPDD., Methods: We studied patients in whom JPDD was detected during endoscopic retrograde cholangiopancreatography. Patients were classified into 3 groups: 1) papilla located inside the diverticulum, 2) papilla located at the edge of the diverticulum and 3) papilla located closer than 3 cm to the diverticulum. The patients were examined with respect to localization of papilla-diverticula and to the association of the localization with pancreaticobiliary disease., Results: We enrolled 274 patients in our study. Biliary stone disease more frequently existed in group 3. The number of patients presenting with obstructive jaundice was higher in groups 2 (83.6%) and 3 (83.3%) than group 1 (66%). Cholangitis was more common in group 1 (21.3%) than in groups 2 (6.7%) and 3 (2.3%). The presence of biliary stone disease among patients presenting with pancreatitis was significantly different between groups 1 and 3 (p = 0.013) and between groups 2 and 3 (p = 0.017). The common bile duct more frequently contained stones or sludge in group 3 than in groups 1 and 2., Conclusion: When the papilla is located close to the JPDD, the incidence of biliary stone disease decreases, and pancreatobiliary diseases are caused mostly in the absence of biliary stone disease.
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- 2014
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238. Ectopic pancreatitis.
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Hoven N and Spilseth B
- Subjects
- Adult, Biopsy, Carcinoma in Situ diagnosis, Carcinoma in Situ pathology, Choristoma pathology, Diagnosis, Differential, Duodenal Diseases pathology, Duodenal Neoplasms diagnosis, Duodenal Neoplasms pathology, Humans, Male, Pancreatitis, Chronic pathology, Stomach Diseases pathology, Stomach Neoplasms diagnosis, Stomach Neoplasms pathology, Tomography, X-Ray Computed, Ultrasonography, Choristoma diagnosis, Duodenal Diseases diagnosis, Pancreas, Pancreatitis, Chronic diagnosis, Pylorus pathology, Stomach Diseases diagnosis
- Published
- 2014
239. The capsule endoscopy "suspected blood indicator" (SBI) for detection of active small bowel bleeding: no active bleeding in case of negative SBI.
- Author
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Tal AO, Filmann N, Makhlin K, Hausmann J, Friedrich-Rust M, Herrmann E, Zeuzem S, and Albert JG
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Duodenal Diseases etiology, False Negative Reactions, False Positive Reactions, Female, Gastrointestinal Hemorrhage etiology, Humans, Ileal Diseases etiology, Jejunal Diseases etiology, Male, Middle Aged, Predictive Value of Tests, ROC Curve, Retrospective Studies, Sensitivity and Specificity, Young Adult, Capsule Endoscopy, Duodenal Diseases diagnosis, Gastrointestinal Hemorrhage diagnosis, Ileal Diseases diagnosis, Jejunal Diseases diagnosis, Software
- Abstract
Objective: Capsule endoscopy (CE) is the gold standard to diagnose small bowel bleeding. The "suspected blood indicator" (SBI) offers an automated detection of active small bowel bleeding but validity of this technique is unknown. The objective was to analyze specificity and sensitivity of the SBI using the second small bowel capsule generation for the detection of active bleeding., Methods: This is a retrospective analysis of all patients (199) who attended our clinic for CE from June 2008 through March 2013. The second-generation PillCam SB 2 capsule was used for detection of (1) luminal blood content and (2) potentially responsible small bowel lesions. The findings of an independent investigator were correlated to SBI findings and a number of SBI markings were analyzed by a receiver operating characteristic (ROC)., Results: In 157/199 cases, no sign of active bleeding or altered blood was detected. One hundred and thirty-seven of these 157 cases provided at least one SBI marking and a mean of 18.4 positive SBI markings per record were found. In 20 cases, neither SBI nor the human investigator detected abnormalities. Thirteen patients showed investigator-detected minor bleeding with mean SBI findings of 36 positive screenshots per record. When major bleeding was diagnosed by the investigator (n = 29), SBI detected a mean of 46.6 SBI-positive markings. SBI turned positive in 179 patients, whereas the investigator detected active bleeding in 42 cases. All patients with active bleeding were detected by SBI (sensitivity 100%, specificity 13%). ROC analysis revealed 51.0 SBI markings being the optimal cutoff for active versus no bleeding (sensitivity 79.1%, specificity 90.4%, misclassification of 15.3%)., Conclusion: The new SBI software is a reliable tool to exclude active bleeding and/or major lesions but analysis of the CE video by a trained investigator is still important for the detection of lesions responsible for past bleeding.
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- 2014
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240. A duodenal duplication cyst manifested by duodenojejunal intussusception and chronic pancreatitis.
- Author
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Kusnierz K, Pilch-Kowalczyk J, Gruszczynska K, Baron J, Lucyga M, and Lampe P
- Subjects
- Adult, Cysts congenital, Cysts diagnosis, Cysts surgery, Duodenal Diseases diagnosis, Duodenal Diseases etiology, Duodenum surgery, Humans, Intussusception diagnosis, Intussusception etiology, Pancreaticoduodenectomy, Pancreatitis, Chronic diagnosis, Pancreatitis, Chronic etiology, Tomography, X-Ray Computed, Duodenal Diseases surgery, Duodenum abnormalities, Intussusception surgery, Pancreatitis, Chronic surgery
- Published
- 2014
- Full Text
- View/download PDF
241. Acquired constricting and restricting lesions of the descending duodenum.
- Author
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Carbo AI, Sangster GP, Caraway J, Heldmann MG, Thomas J, and Takalkar A
- Subjects
- Algorithms, Duodenal Obstruction diagnosis, Humans, Intestinal Atresia, Diagnostic Imaging, Duodenal Diseases diagnosis
- Abstract
The descending duodenum is a structure with distinct pathologic processes and anatomic relationships that requires a systematic approach to the differential diagnosis. Because of its tubular shape and fixed position in the retroperitoneum, both intrinsic duodenal and juxtaduodenal diseases are capable of producing luminal narrowing and obstruction. Duodenal lesions may be located in the mucosa or submucosa. Extraduodenal lesions may originate in adjacent structures--such as the pancreas, liver, gallbladder, colon, and lymph nodes--or from other retroperitoneal structures. Causes of duodenal obstruction include intraluminal masses, such as bezoars; duodenal inflammation, such as as peptic ulcers and Crohn disease; hematomas; and benign or malignant mucosal and intramural tumors. Pancreatic inflammation; tumors; and extrinsic compression caused by gallbladder processes, hepatic masses, retroperitoneal fluid collections, and tumors, including lymphoma, may produce duodenal obstruction. Abdominal radiography, barium studies, multidetector computed tomography, magnetic resonance imaging, and positron emission tomography may be used to depict and characterize duodenal strictures. Integration of imaging, clinical, laboratory, and endoscopic findings plays a major role in establishing a diagnosis of obstructive duodenal strictures., (©RSNA, 2014.)
- Published
- 2014
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242. An unusual cause of small bowel obstruction.
- Author
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Liang JJ and Hart PA
- Subjects
- 4-Hydroxycoumarins adverse effects, Adult, Anticoagulants adverse effects, Biopsy, Blood Coagulation drug effects, Blood Component Transfusion, Duodenal Diseases blood, Duodenal Diseases chemically induced, Duodenal Diseases diagnosis, Duodenal Diseases therapy, Hematoma diagnosis, Hematoma therapy, Humans, Intestinal Obstruction diagnosis, Intestinal Obstruction therapy, Jejunal Diseases blood, Jejunal Diseases chemically induced, Jejunal Diseases diagnosis, Jejunal Diseases therapy, Male, Risk Factors, Rodenticides adverse effects, Tomography, X-Ray Computed, Treatment Outcome, Vitamin K therapeutic use, Duodenal Diseases complications, Hematoma complications, Intestinal Obstruction etiology, Jejunal Diseases complications
- Published
- 2014
- Full Text
- View/download PDF
243. Immunoglobulin G4-related periaortitis complicated by aortic rupture and aortoduodenal fistula after endovascular AAA repair.
- Author
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Kasashima S, Kawashima A, Kasashima F, Endo M, Matsumoto Y, Kawakami K, Kayahara M, Ohta H, Yano M, and Marukawa Y
- Subjects
- Aged, Aortic Aneurysm, Abdominal diagnosis, Aortic Aneurysm, Abdominal immunology, Aortic Rupture diagnosis, Aortic Rupture immunology, Aortitis complications, Aortitis diagnosis, Aortitis drug therapy, Aortography methods, Biopsy, Blood Vessel Prosthesis Implantation, Duodenal Diseases diagnosis, Endoscopy, Gastrointestinal, Escherichia coli Infections immunology, Escherichia coli Infections microbiology, Fatal Outcome, Gastrointestinal Hemorrhage immunology, Humans, Immunocompromised Host, Intestinal Fistula diagnosis, Male, Risk Factors, Steroids adverse effects, Time Factors, Tomography, X-Ray Computed, Vascular Fistula diagnosis, Aortic Aneurysm, Abdominal surgery, Aortic Rupture surgery, Aortitis immunology, Duodenal Diseases immunology, Endovascular Procedures adverse effects, Immunoglobulin G analysis, Intestinal Fistula immunology, Vascular Fistula immunology
- Abstract
Purpose: To report a rare and complicated case of immunoglobulin (Ig) G4-related periaortitis involving both the aortic wall and the retroperitoneum without aneurysmal formation., Case Report: A 79-year-old man with IgG4-related periaortitis suffered aortic rupture despite a normal caliber aorta after 6 months of steroid therapy (20 mg/d). Endovascular repair with an aortic cuff sealed the rupture. Steroid therapy was halted 2 weeks later due to infection. Four months later, a biopsy during esophagogastroduodenoscopy to investigate gastrointestinal bleeding suggested a relapse of IgG4-RD in the duodenum. Subsequent aortoduodenal fistula formation proved fatal. Generally, IgG4-related periaortitis does not result in such complications due to the absence of aneurysm formation and a thick aortic wall., Conclusions: Our report highlights a rare case of IgG4-related periaortitis where complications resulted following steroid therapy and surgical intervention, emphasizing the difficulties in dealing with IgG4-related cardiovascular lesions.
- Published
- 2014
- Full Text
- View/download PDF
244. Dynamic contrast-enhanced MRI findings of acute pancreatitis in ectopic pancreatic tissue: case report and review of the literature.
- Author
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Thangasamy SJ, Zheng L, Mcintosh L, Lee P, and Roychowdhury A
- Subjects
- Acute Disease, Choristoma complications, Contrast Media, Diagnosis, Differential, Duodenal Diseases complications, Humans, Image Enhancement methods, Jejunal Diseases complications, Male, Middle Aged, Pancreatitis etiology, Choristoma diagnosis, Duodenal Diseases diagnosis, Jejunal Diseases diagnosis, Magnetic Resonance Imaging methods, Pancreas, Pancreatitis diagnosis
- Abstract
Context: Acute pancreatitis in ectopic pancreatic tissue is an uncommon cause of acute abdominal pain and can be difficult to diagnose on imaging. Our aim is to raise awareness and aid in the diagnosis of this entity by highlighting helpful dynamic contrast-enhanced MRI imaging findings., Case Report: We report a 51-year-old man with acute onset epigastric pain presented to ER. With the presence of elevated serum lipase, the clinical diagnosis of acute pancreatitis was made. Contrast enhanced CT demonstrated normal pancreas and a focal mass at the duodenojejunal flexure, mimicked a neoplasm. Subsequent dynamic contrast enhanced MR images demonstrated enhancement pattern of the lesion similar to the native pancreatic tissue enhancement, a finding raised the possibility of acute pancreatitis in ectopic pancreatic tissue, but tumor was not excluded. Finally, patient undergone surgical bowel resection including the suspected mass that was proved as an ectopic pancreatic tissue on microscopic examination., Conclusion: We concluded that findings on dynamic contrast enhanced MR imaging can be characteristic and diagnostic of acute pancreatitis in ectopic pancreatic tissue in the appropriate clinical setting.
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- 2014
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- View/download PDF
245. Duodenal perforation: an unusual complication of sickle cell anemia.
- Author
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Acıpayam C, Aldıç G, Akçora B, Çelikkaya ME, Aşkar H, and Dorum BA
- Subjects
- Adolescent, Duodenal Diseases diagnosis, Duodenal Diseases surgery, Humans, Intestinal Perforation diagnosis, Intestinal Perforation surgery, Male, Anemia, Sickle Cell complications, Duodenal Diseases etiology, Intestinal Perforation etiology
- Abstract
Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia.
- Published
- 2014
- Full Text
- View/download PDF
246. Ultrasound, CT and FDG PET-CT of a duodenal granuloma in a dog.
- Author
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Jeon S, Kwon SY, Cena R, Lee JH, Cho KO, Min JJ, and Choi J
- Subjects
- Animals, Dogs, Duodenal Diseases diagnosis, Duodenal Diseases diagnostic imaging, Duodenal Diseases pathology, Female, Granuloma diagnosis, Granuloma diagnostic imaging, Granuloma pathology, Positron-Emission Tomography methods, Ultrasonography, Duodenal Diseases veterinary, Fluorodeoxyglucose F18, Granuloma veterinary, Positron-Emission Tomography veterinary, Tomography, X-Ray Computed veterinary
- Abstract
A 12-year-old spayed female Yorkshire Terrier with intermittent vomiting was diagnosed with regional granulomatous enteritis through histopathological examination. On ultrasonography and computed tomography, a focal thickened duodenal wall showed a mass-like appearance with indistinct wall layers. Marked uptake of (18)F-fluorodeoxyglucose was observed from the mass on positron emission tomography-computed tomography. Regional granulomatous enteritis is a rare form of inflammatory bowel disease and may have imaging features similar to intestinal tumors. This is the first study describing the diagnostic imaging features of ultrasonography, computed tomography and positron emission tomography-computed tomography for regional granulomatous enteritis in a dog.
- Published
- 2014
- Full Text
- View/download PDF
247. [Gastroduodenal cryptococcosis in an AIDS patient].
- Author
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Roig-Rico P, Delgado-Sánchez E, Marín-Tordera D, Chulia-Gómez MT, Mayol-Belda MJ, and Martínez-Egea A
- Subjects
- AIDS-Related Opportunistic Infections drug therapy, Cryptococcosis drug therapy, Duodenal Diseases drug therapy, Fatal Outcome, Humans, Male, Middle Aged, Stomach Diseases drug therapy, AIDS-Related Opportunistic Infections diagnosis, Cryptococcosis diagnosis, Duodenal Diseases diagnosis, Stomach Diseases diagnosis
- Published
- 2014
- Full Text
- View/download PDF
248. Lemmel's syndrome, an unusual cause of abdominal pain and jaundice by impacted intradiverticular enterolith: case report.
- Author
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Kang HS, Hyun JJ, Kim SY, Jung SW, Koo JS, Yim HJ, and Lee SW
- Subjects
- Abdominal Pain, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, Cholangiopancreatography, Magnetic Resonance, Cholangitis complications, Diverticulum, Duodenal Diseases complications, Female, Fluoroscopy, Gallstones diagnosis, Gallstones therapy, Humans, Tomography, X-Ray Computed, Duodenal Diseases diagnosis, Jaundice, Obstructive complications
- Abstract
Duodenal diverticula are detected in up to 27% of patients undergoing upper gastrointestinal tract evaluation with periampullary diverticula (PAD) being the most common type. Although PAD usually do not cause symptoms, it can serve as a source of obstructive jaundice even when choledocholithiasis or tumor is not present. This duodenal diverticulum obstructive jaundice syndrome is called Lemmel's syndrome. An 81-yr-old woman came to the emergency room with obstructive jaundice and cholangitis. Abdominal CT scan revealed stony opacity on distal CBD with CBD dilatation. ERCP was performed to remove the stone. However, the stone was not located in the CBD but rather inside the PAD. After removal of the enterolith within the PAD, all her symptoms resolved. Recognition of this condition is important since misdiagnosis could lead to mismanagement and therapeutic delay. Lemmel's syndrome should always be included as one of the differential diagnosis of obstructive jaundice when PAD are present.
- Published
- 2014
- Full Text
- View/download PDF
249. Endoscopic retroflexion treats bleed within duodenal bulb.
- Author
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Bose KP, Gutkin E, and Yalamanchi V
- Subjects
- Aged, Arteriovenous Malformations diagnosis, Arteriovenous Malformations surgery, Duodenal Diseases surgery, Electrocoagulation methods, Female, Gastrointestinal Hemorrhage surgery, Humans, Duodenal Diseases diagnosis, Duodenoscopy methods, Gastrointestinal Hemorrhage diagnosis
- Published
- 2014
- Full Text
- View/download PDF
250. [Partial bowel occlusion due to duodenal injury].
- Author
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Senderovsky M, Lasa J, Peralta D, Moore R, Fanjul I, Zubiaurre I, Soifer L, Arbat J, and Avagnina A
- Subjects
- Adult, Duodenal Diseases diagnosis, Humans, Intestinal Obstruction diagnosis, Male, Duodenal Diseases complications, Intestinal Obstruction etiology
- Published
- 2014
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