Closed Loop Duodenal Obstruction Secondary to Pancreatic Carcinoma: A Case Report

2019 ◽  
Vol 22 (4) ◽  
pp. 280-286 ◽  
Author(s):  
Zhihong Shen ◽  
Jianhua Yu ◽  
Haijun Tang ◽  
Baochun Lu
Keyword(s):  
Duodenal Obstruction ◽  
Closed Loop ◽  
Pancreatic Tumor ◽  
Uncinate Process ◽  
Resection Margins ◽  
Duodenal Wall ◽  
Tumor Mass ◽  
First Choice ◽  
Gastrointestinal Imaging ◽  
Upper Gastrointestinal

Background: Patients with pancreatic adenocarcinoma may develop into duodenal obstruction during the course of their disease. The diagnosis of obstruction can be generally achieved by means of imaging technologies. Case and Outcome: We reported a rare case of pancreatic tumor with duodenal obstruction accompanied by obstructive symptoms, which was finally confirmed by laparotomy. A 68-year-old man was admitted to our department with a 3-day medical history of upper abdominal pain, nausea and vomiting. The diagnosis of duodenal obstruction was established by means of various imagings including computed tomography (CT) scan, gastroscopy and upper gastrointestinal imaging. Upper gastrointestinal imaging and magnetic resonance imaging (MRI) showed extrinsic tumor mass was noted at the second and third portion of the duodenum accompanied by duodenal obstruction and dilatation, respectively. Laparotomy confirmed a tumor mass arising from the head and uncinate process of pancreas, which had invaded the second and third portions of the duodenum and caused closed loop obstruction. A pancreaticoduodenectomy (Whipple procedure) was performed followed by therapeutic trade-off according to intraoperative exploration. Postoperative histopathology revealed pancreatic tumor only infiltrated duodenal wall, while resection margins of pancreas, common bile duct and duodenum were all negative. The patient was cured and discharged home 12 days after surgery. Conclusion: The present case indicated radical operation in our study appeared to be the first choice treatment for patients with malignant duodenal obstruction.

scholarly journals Solitary extramedullary plasmacytoma of the duodenum and pancreas: A case report and review of the literature

2016 ◽  
Vol 73 (4) ◽  
pp. 402-407
Author(s):  
Mile Ignjatovic ◽  
Mihailo Bezmarevic ◽  
Snezana Cerovic
Keyword(s):  
Case Report ◽  
Chylous Ascites ◽  
Extramedullary Plasmacytoma ◽  
Uncinate Process ◽  
Tumor Formation ◽  
Duodenal Wall ◽  
Adequate Treatment ◽  
Gastrointestinal Obstruction ◽  
Duodenal Lumen ◽  
Upper Gastrointestinal

Introduction. The extramedullary plasmacytomas (EMPs) are rare tumors of plasma cell disorders which are rarely found in the duodenum. We presented a case of solitary EMPs involving the duodenum and pancreas successfully treated by surgical resection after failure of chemotherapy. Case report. A 55-year-old female with previously diagnosed solitary EMP of the duodenum was admitted to our institution after failure of three cycles of vincristine, adriablastine, dexamethasone (VAD) chemotherapy regimen with an upper gastrointestinal obstruction. On admission computed tomography of the abdomen showed tumor in the region of the second part of duodenum and uncinate process of the pancreas with a complete duodenal obstruction. Intraoperatively a tumor formation was in the region of the second duodenal part, originated from the wall of duodenum with the total diameter of 7 x 5 cm, covering the entire circumference of duodenal wall leaded to a narrowing of duodenal lumen to the thigh gap with an upper gastrointestinal obstruction. Infiltration in the head of the pancreas and uncinate process were also found. The Whipple?s procedure was performed but postoperative course was complicated by rapidly refilling chylous ascites which was resolved 4 days after the surgery. Conclusion. Each patient with gastrointestinal EMPs should be considered separately and in timely manner, thus adequate treatment could provide local disease control.

Surgical Management of Hiatal Hernia in Children with Asplenia Syndrome

2016 ◽  
Vol 27 (03) ◽  
pp. 274-279
Author(s):  
Koji Fukumoto ◽  
Masaya Yamoto ◽  
Hiroshi Nouso ◽  
Masakatsu Kaneshiro ◽  
Mariko Koyama ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Duodenal Obstruction ◽  
Abdominal Cavity ◽  
The Other ◽  
Esophageal Hiatus ◽  
Thoracic Cavity ◽  
Toupet Fundoplication ◽  
Cavity Volume ◽  
Upper Gastrointestinal ◽  
Asplenia Syndrome

Purpose Patients with asplenia syndrome (AS) are likely to have upper gastrointestinal tract malformations such as hiatal hernia. This report discusses the treatment of such conditions. Methods Seventy-five patients with AS underwent initial palliation in our institution between 1997 and 2013. Of these, 10 patients had hiatal hernia. Of the patients with hiatal hernia, 6 had brachyesophagus and 7 had microgastria. Results Of the 10 patients with hiatal hernia, 9 underwent surgery in infancy (7 before Glenn operation, 2 after Glenn operation). Two underwent typical Toupet fundoplication, and the other 7 underwent atypical repair including reduction of the stomach. Two patients with atypical repair showed recurrence of hernia and required reoperation. Three patients required reoperation due to duodenal obstruction. Duodenal obstruction occurred due to preduodenal portal vein or abnormal vessels compressing the duodenum. Obstructive symptoms were not seen in any cases preoperatively. Conclusions In patients with hiatal hernia, typical fundoplication is often difficult because most have concomitant brachyesophagus, microgastria, and hypoplasia of the esophageal hiatus. However, we should at least reduce the stomach to the abdominal cavity as early as possible to increase thoracic cavity volume and allow good feeding. Increasing the volume of the thoracic cavity thus makes Glenn and Fontan circulations more stable. Duodenal obstruction secondary to vascular anomalies is also common, so the anatomy in the area near the duodenum should be evaluated pre- and intraoperatively.

Pancreatitis crónica del surco pancreatoduoenal: un desafío diagnóstico y terapéutico. Reporte de un caso

2020 ◽  
Vol 50 (2) ◽  
Author(s):  
Claudio Murillo Matamoros ◽  
Marta Muñiz Muñoz ◽  
Miguel Suárez Matías ◽  
Pablo Olcina Domínguez ◽  
Laura Valiente González ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Endoscopic Ultrasound ◽  
Duodenal Obstruction ◽  
Imaging Techniques ◽  
Definitive Diagnosis ◽  
Duodenal Wall ◽  
Complex Anatomy ◽  
History Of ◽  
Uncertain Etiology

Groove pancreatitis is a very uncommon type of chronic pancreatitis of uncertain etiology that occurs in the pancreatoduodenal groove. Despite the great advances in imaging techniques, making a definitive diagnosis is difficult because of the complex anatomy of this area. Therefore, surgical treatment is often required due to the impossibility of excluding malignancy. We present the case of a patient with a history of chronic pancreatitis admitted due to duodenal obstruction. The diagnosis was difficult, especially for the need to exclude the neoplasms of the duodenal-pancreatic area. Endoscopic ultrasound was essential to establish a definitive diagnosis, allowing FNAP and correct assessment of the duodenal wall.

Barium Appendicitis After Upper Gastrointestinal Imaging

2010 ◽  
Vol 38 (2) ◽  
pp. 148-149 ◽  
Author(s):  
Nathan M. Novotny ◽  
Keith D. Lillemoe ◽  
Mark E. Falimirski
Keyword(s):  
Gastrointestinal Imaging ◽  
Barium Appendicitis ◽  
Upper Gastrointestinal

scholarly journals Pancreatic tumor mass in a xenograft mouse model is decreased by treatment with therapeutic stem cells following introduction of therapeutic genes

2013 ◽  
Vol 30 (3) ◽  
pp. 1129-1136 ◽  
Author(s):  
DOO-JIN KIM ◽  
BO-RIM YI ◽  
HYE-RIM LEE ◽  
SEUNG U. KIM ◽  
KYUNG-CHUL CHOI
Keyword(s):  
Stem Cells ◽  
Mouse Model ◽  
Pancreatic Tumor ◽  
Tumor Mass ◽  
Xenograft Mouse Model ◽  
Therapeutic Genes

scholarly journals Percutaneous Computed Tomography-Guided Coaxial Core Biopsy for the Diagnosis of Pancreatic Tumors

2019 ◽  
Vol 8 (10) ◽  
pp. 1633 ◽  
Author(s):  
Su ◽  
Liu ◽  
Chao ◽  
Chiang ◽  
Yen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pancreatic Tumor ◽  
Pancreatic Tumors ◽  
Ultrasound Guided ◽  
Medical Centers ◽  
First Choice ◽  
Life Threatening ◽  
Tissue Acquisition ◽  
Site Evaluation ◽  
Sensitivity Specificity

Endoscopic, ultrasound-guided tissue acquisition (EUS-TA) with rapid on-site evaluation is recommended as a first choice in the diagnosis of pancreatic lesions. Since EUS facilities and rapid on-site evaluation are not widely available, even in medical centers, an alternative for precise diagnoses of pancreatic tumor is warranted. The percutaneous computed tomography-guided, core needle biopsy (CT-CNB) is a commonly applicable method for biopsies. Our institute has developed a fat-transversing approach for pancreatic biopsies which is able to approach most tumors in the pancreas without penetrating organs or vessels. Herein, we report a 15-year experiment of pancreatic tumor coaxial CT-CNB in 420 patients. The success rate of tissue yielding by the technique was 99.3%. The overall sensitivity, specificity, and accuracy were 93.2%, 100%, and 93.4%, respectively. The diagnostic accuracy could be increased to 96.4% in 2016–2018 (after the learning curve period). The overall complication rate was 8.6%. Neither life-threatening major complications, nor seeding through the biopsy tract, were observed. Our study supported the hypothesis that CT-CNB could be a complementary option for diagnostic tissue acquisition in patients with unresectable or metastatic pancreatic tumors when EUS-TA is either unsuitable or unavailable.

scholarly journals Missed duodenal web with foreign body impaction in an operated case of midgut malrotation with Down′s syndrome - A diagnosis delayed by endoscopy

2013 ◽  
Vol 04 (01) ◽  
pp. 010-012
Author(s):  
Krushnakumar Kesan ◽  
Abhaya Gupta ◽  
Rahul Kumar Gupta ◽  
Paras Kothari ◽  
Ritesh Ranjan ◽  
...  
Keyword(s):  
Foreign Body ◽  
Duodenal Obstruction ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Foreign Body Removal ◽  
Midgut Malrotation ◽  
Foreign Body Impaction ◽  
Duodenal Web ◽  
Upper Gastrointestinal

ABSTRACT“Always look for duodenal obstruction in a case of malrotation”, this dictum has to be followed. The patient was operated for midgut malrotation at day 2 of life followed by foreign body removal by upper gastrointestinal endoscopy at 2 years of age. We report atwo and half year male child with Down′s syndrome who presented to us with history suggestive of recurrent upper gastrointestinal tract obstruction. During surgery a post sphincteric duodenum web was confirmed and foreign body (berry seed) which had impacted proximal to it was removed. The web was excised and the duodenum, split longitudinally, sutured transversely. The postoperative course was uneventful and patient is asymptomatic at follow up. This case illustrates that diagnosis was delayed for 2΍ years after initial presentation in early neonatal age. (Dig Endosc 2013;4(1):10–12)

scholarly journals Consensus of the Present and Prospects on Endoscopic Diagnosis and Treatment in East Asian Countries

2012 ◽  
Vol 2012 ◽  
pp. 1-9
Author(s):  
Takeshi Kamiya ◽  
Takashi Joh ◽  
Jose D. Sollano ◽  
Qi Zhu ◽  
Udom Kachintorn ◽  
...  
Keyword(s):  
East Asian ◽  
The Philippines ◽  
Endoscopic Diagnosis ◽  
Diagnosis And Treatment ◽  
Gastric Adenoma ◽  
Asian Countries ◽  
First Choice ◽  
New Instruments ◽  
Representative Member ◽  
Upper Gastrointestinal

Background and Aim. New diagnostic or therapeutic methods in endoscopy have been used. Current clinical application of these procedures is not well known. The aim of this study is to investigate the present situation on endoscopic diagnosis and treatment of gastrointestinal disorders in East Asian countries. Method. A representative member from the International Gastrointestinal Consensus Symposium Committee provided a questionnaire to physicians in China, Indonesia, Japan, Korea, the Philippines, and Thailand. Results. In total, 514 physicians including gastroenterologists, surgeons, and general practitioners enrolled. The most frequently occurring disorder as the origin of upper gastrointestinal bleeding is gastric ulcer. Capsule endoscopy is selected as the first choice for the diagnosis of small intestine bleeding. The second choice was double-balloon endoscopy or angiography. For patients with gastric adenoma, the number of physicians who choose endoscopic mucosal resection is larger than those selecting endoscopic submucosal dissection (ESD) in China, Indonesia, the Philippines, and Thailand. ESD is chosen first in Japan and Korea. Conclusion. New instruments or techniques on endoscopy have not come into wide use yet, and there is diversity in the situation on it in Asian countries. We should unify the endoscopic diagnostic criteria or treated strategy in patients with GI disease.

scholarly journals Radiotherapy in Osteosarcomas

2018 ◽  
Vol 1 (Supplement) ◽  
pp. 31
Author(s):  
R. Mitrică ◽  
L. Şerbănescu ◽  
O. Trifănescu
Keyword(s):  
Local Control ◽  
Proton Therapy ◽  
Clinical Studies ◽  
Residual Disease ◽  
Lung Metastases ◽  
Current Treatment ◽  
Resection Margins ◽  
First Choice ◽  
Lung Irradiation ◽  
Whole Lung Irradiation

Abstract Osteosarcoma represents a rare primary tumor of the bone, but it ranks 5th among children and adolescents. When diagnosed, many patients already have a disseminated disease at subclinical level. Current treatment includes surgery and chemotherapy. Radiotherapy is not commonly indicated, especially given the radioresistant characteristic of this type of cancer and it is usually administered for residual disease after surgery, inoperable tumors or in palliation, such as whole lung irradiation. The purpose of this paper was to identify the real contribution of radiotherapy in osteosarcomas, with solutions to improve local control and survival. We reviewed clinical studies, starting with the period before chemotherapy, in order to identify treatment techniques related criteria that may influence local control, survival, and secondary toxicity. Modern radiotherapy techniques are outlined with their dosimetric advantages. Following the 1990s, the combination between proper surgery and chemotherapy has eliminated the need for pre-operative radiotherapy. Most clinical studies have used adjuvant radiotherapy for patients with positive resection margins, with good results but hard to dissociate from those of the concurrently administered chemotherapy. Proton therapy is frequently indicated for these patients, due to the healthy tissue sparing characteristics. Studies have pointed out the correlation between radiotherapy response and tumor size, total administered dose, chemo sensitivity. Whole lung irradiation for patients with lung metastases is inferior to chemotherapy. Radiotherapy associated complications include joint fibrosis with reduced functional capabilities, bone fracture, allograft loss and carcinogenic risk. Currently, radiotherapy is not the first choice when treating osteosarcomas, but new evidence is emerging for combining modern techniques, such as proton therapy with surgery and chemotherapy for patients with incomplete resections or inoperable tumors.

Sign in / Sign up

Export Citation Format

Share Document