scholarly journals Intramucosal duodenal adenocarcinoma concomitant with Saint’s triad

2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Matheus Dantas Gomes Gonçalves ◽  
Vinicius Grigolli ◽  
Thereza Cristina Carvalho Kalmar ◽  
Vitorino Modesto dos Santos ◽  
Lucimara Sonjia Villela ◽  
...  
Keyword(s):  
Case Reports ◽  
Endoscopic Biopsy ◽  
Upper Gastrointestinal Endoscopy ◽  
Tubulovillous Adenoma ◽  
Duodenal Tumor ◽  
Intestinal Neoplasms ◽  
Saint’S Triad ◽  
Intramucosal Adenocarcinoma ◽  
Colonic Diverticula ◽  
Suspicion Index

Duodenal tubulovillous adenomas are rare and have malignant potential. Their successful management depends on the preoperative diagnosis and adequate excision. Endoscopic mucosal resection or submucosal dissection can control superficial tumors. Adenocarcinoma of the duodenum may originate in tubular or tubulovillous adenoma, and possible diagnostic challenges occur concerning the endoscopic biopsy findings. We report a 62-year-old female with chronic epigastric burning and a bolus sensation. Upper gastrointestinal endoscopy showed a non-ampullary duodenal tumor, and the biopsy study diagnosed a tubulovillous adenoma. Further mucosectomy revealed an intramucosal adenocarcinoma in a tubulovillous adenoma with a tumor-free pedicle. Besides the intestinal neoplasms, the patient had the diagnosis of classical Saint’s triad; and the manifestations were hiatus hernia, gallbladder disorder, and colonic diverticula. The objective is to report two scarcely described conditions and comment on controversial points of view about the concomitance of Saint’s triad and malignancy. Case reports can reduce late diagnosis, enhancing the suspicion index on rare diseases.

Role of upper gastrointestinal endoscopy with routine standardized endoscopic biopsy in AIDS

2002 ◽  
Vol 14 (4) ◽  
pp. 152-155 ◽  
Author(s):  
Carlos A. Cappellanes ◽  
Kiyoshi Hashiba ◽  
Horus A. Brasil ◽  
Marco A. D’Assunção ◽  
Daniel Moribe ◽  
...  
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Endoscopic Biopsy ◽  
Upper Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal

scholarly journals Whipple's disease: rare disorder and late diagnosis

2012 ◽  
Vol 54 (5) ◽  
pp. 293-297 ◽  
Author(s):  
Viviane Plasse Renon ◽  
Marcelo Campos Appel-da-Silva ◽  
Rafael Bergesch D'Incao ◽  
Rodrigo Mayer Lul ◽  
Luciana Schmidt Kirschnick ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Disease Diagnosis ◽  
Endoscopic Biopsy ◽  
Upper Gastrointestinal Endoscopy ◽  
Whipple’S Disease ◽  
Whipple's Disease ◽  
Polymerase Chain ◽  
One Year ◽  
Infectious Disorder

Whipple's disease is a rare systemic infectious disorder caused by the bacterium Tropheryma whipplei. We report the case of a 61-year-old male patient who presented to emergency room complaining of asthenia, arthralgia, anorexia, articular complaints intermittent diarrhea, and a 10-kg weight loss in one year. Laboratory tests showed the following results: Hb = 7.5 g/dL, albumin = 2.5 mg/dL, weight = 50.3 kg (BMI 17.4 kg/m²). Upper gastrointestinal endoscopy revealed areas of focal enanthema in the duodenum. An endoscopic biopsy was suggestive of Whipple's disease. Diagnosis was confirmed based on a positive serum polymerase chain reaction. Treatment was initiated with intravenous ceftriaxone followed by oral trimethoprim-sulfamethoxazole. After one year of treatment, the patient was asymptomatic, with Hb = 13.5 g/dL, serum albumin = 5.3 mg/dL, and weight = 70 kg (BMI 24.2 kg/m²). Whipple's disease should be considered a differential diagnosis in patients with prolonged constitutional and/or gastrointestinal symptoms. Appropriate antibiotic treatment improves the quality of life of patients.

scholarly journals Rescue Therapy of Delayed Gastric Perforation Caused by an External Drainage Using an Over-the-Scope Clip

2019 ◽  
Vol 28 ◽  
pp. 241-244
Author(s):  
Andrada Seicean ◽  
Carmen Cruciat ◽  
Radu Motocu ◽  
Cristina Pojoga ◽  
Marcel Gheorghiu ◽  
...  
Keyword(s):  
Case Reports ◽  
Rescue Therapy ◽  
Gastric Varix ◽  
Bleeding Risk ◽  
Upper Gastrointestinal Endoscopy ◽  
Gastric Fistula ◽  
Sudden Increase ◽  
External Drainage ◽  
History Of ◽  
Over The Scope Clip

This case reports a iatrogenic gastric fistula due to external draining successfully closed by using an over- the-scope clip. A 50-year old patient with a history of acute pancreatitis, segmental portal hypertension and splenectomy for splenic rupture, with long-term external drainage for a low volume pancreatic fistula, was referred to our hospital. The patient noticed the occurrence of a sudden increase of the drain flow and the immediate drainage of ingested liquid, with no fever or pain. An upper gastrointestinal endoscopy evidenced the gastric fistula with the presence of the drain inside the stomach near a gastric varix. The surgical approach was inappropriate due to bleeding risk. An over-the-scop clip was placed succeeding to stop the gastric flow. The external fistula closed one week later.

scholarly journals Intramucosal esophageal dissection after esophagogastroduodenoscopy: two case reports

2021 ◽  
pp. 198
Author(s):  
Keyword(s):  
Ct Scan ◽  
Subcutaneous Emphysema ◽  
Case Reports ◽  
Upper Gastrointestinal Endoscopy ◽  
Conservative Approach ◽  
First Case ◽  
Esophageal Dissection ◽  
Dental Arcade ◽  
Sharp Foreign Body ◽  
Upper Gastrointestinal

Introduction: Intramucosal esophageal dissection (IED) is an uncommon disorder, described as the separation of the mucosa and/or submucosa from deeper muscular layers due to abrupt increase in intraesophageal pressure. Case presentation: The first case il that of a 52 – years old female patient who underwent an esophagogastroduodenoscopy for control. After the procedure an extensive subcutaneous emphysema of the neck and a massive pneumomediastinum occurred. The patient was successfully treated with a conservative approach. The second case is that of a 43-years old male patient affected by Down’s Syndrome, who underwent an esopagogastroduodenoscopy because of persisting dysphagia. The endoscopic showed the presence of a serrated stricture at 20 centimeters from dental arcade. After the procedure he fell dysphagia. A neck-chest TC-SCAN showed superior and posterior pneumomediastinum and subcutaneous emphysema, without signs of mediastinitis. The patient was successfully treated with conservative approach. After a few days, a new chest CT-SCAN showed the presence of an anomalous right subclavian artery arising from the descending part of the aortic arch, causing dysphagia lusoria. Discussion: The causes of IED include iatrogenic instrumentation, hemostatic applications, mucosal injuries from ingestion of sharp foreign body, or spontaneous. A fluoroscopic upper gastrointestinal series or upper gastrointestinal endoscopy has been widely used to diagnose IED. CT and magnetic resonance are useful for differential diagnosis. In the absence of signs of mediastinitis management is conservative. Conclusion: CT SCAN should be the first exam to perform in the suspicion of IED. The first line treatment should be conservative. In case of the onset of complications and in patients who are refractory to conservative management, endoscopic or surgical treatment are indicated.

scholarly journals Metastatic melanoma of the stomach and the duodenum

2006 ◽  
Vol 14 (1-2) ◽  
pp. 60-61 ◽  
Author(s):  
Daniela Benedeto-Stojanov ◽  
Aleksandar Nagorni ◽  
Vesna Zivkovic ◽  
Jovica Milanovic ◽  
Dragan Stojanov
Keyword(s):  
Malignant Melanoma ◽  
Metastatic Melanoma ◽  
Duodenal Bulb ◽  
Gastrointestinal Symptoms ◽  
Endoscopic Biopsy ◽  
Upper Gastrointestinal Endoscopy ◽  
Primary Malignancy ◽  
Melanoma Metastases ◽  
History Of ◽  
One Year

A case of metastatic melanoma of the antrum and duodenal bulb is reported with rare endoscopic findings. A 59-year-old male patient was presented with nausea, vomiting, and abdominal pain one year after excision of malignant melanoma from the back. The tumor was classified as Clark IV, Breslow III. Upper gastrointestinal endoscopy revealed one melanotic polypoid mass with ulcerations at the tip in the antrum and two in the duodenal bulb. Endoscopic biopsy of these polypoid masses showed malignant melanoma metastases. Patients with gastrointestinal symptoms and a history of melanoma should be investigated for the presence of gastrointestinal metastases even if the original primary malignancy was diagnosed years prior to the patient presentation.

Primary Pure Squamous Cell Carcinoma of the Duodenum: a Case Report

2014 ◽  
Vol 23 (3) ◽  
pp. 329-332 ◽  
Author(s):  
Florin Graur ◽  
Emil Mois ◽  
Nadim Al Hajjar
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Case Reports ◽  
Metastatic Tumor ◽  
Positive Outcome ◽  
X Rays ◽  
Rare Type ◽  
Duodenal Tumor ◽  
Immunohistochemical Markers

Primary pure squamous cell carcinoma of the duodenum is a very rare type of duodenal neoplasm and is more likely to be presented as a metastatic tumor. The literature offers little information on this subject and includes very few articles and case reports. Laboratory tests, CT and ultrasound examinations, x-rays and immunohistochemical markers assisted us in making this rare diagnosis of primary squamous cell carcinoma of the duodenum in a 47 year old female patient, who presented with weight loss and melena. The 8 cm duodenal tumor with pancreas invasion was resected by a cephalic duodenopancreatectomy. The pathology examination revealed a primary duodenal squamous cell carcinoma moderately differentiated (G2), invasive in the head of the pancreas, with keratinization, stage II B (pT4N0MxL0V0R0). Positive outcome after surgery was highlighted, no recurrence being registered at the 6 month CT scan follow-up.

scholarly journals Rapunzel Syndrome in a Seven-Year-Old Girl

2021 ◽  
Author(s):  
Aviral Gupta ◽  
Sarvesh C. Mishra ◽  
Vijay D. Upadhyay ◽  
Pujana Kanneganti
Keyword(s):  
Abdominal Pain ◽  
Gold Standard ◽  
Gastrointestinal Endoscopy ◽  
Case Reports ◽  
Abdominal Mass ◽  
Upper Gastrointestinal Endoscopy ◽  
Surgical Removal ◽  
Rare Entity ◽  
Rapunzel Syndrome ◽  
Upper Gastrointestinal

AbstractRapunzel syndrome is a rare entity with less than hundred case reports cited in the literature. In this, there is presence of a trichobezoar in the stomach which extends into the small intestine or beyond. It can typically cause abdominal pain and nausea, but can also present as an asymptomatic abdominal mass, progressing to abdominal obstruction and perforation. Many of these patients have associated psychiatric disorder. The gold standard for diagnosis is upper gastrointestinal endoscopy and treatment is surgical removal. Herein, we present surgical images of Rapunzel syndrome in a seven-year-old girl.

Cold polypectomy for duodenal adenomas: a prospective clinical trial

Endoscopy ◽  
2017 ◽  
Vol 49 (08) ◽  
pp. 776-783 ◽  
Author(s):  
Daisuke Maruoka ◽  
Tomoaki Matsumura ◽  
Shingo Kasamatsu ◽  
Hideaki Ishigami ◽  
Takashi Taida ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Colorectal Polyps ◽  
Endoscopic Biopsy ◽  
R0 Resection ◽  
Upper Gastrointestinal Endoscopy ◽  
Incomplete Resection ◽  
En Bloc ◽  
Clinical Trial Registration ◽  
Delayed Bleeding ◽  
Duodenal Adenomas

Abstract Background and study aims Endoscopic resection is effective in treating nonampullary duodenal adenomas but has a high incidence of complications. Cold polypectomy, including cold forceps polypectomy (CFP) and cold snare polypectomy (CSP), is safe and effective in treating colorectal polyps. However, its utility in sporadic nonampullary duodenal adenomas has not been investigated. The purpose of this prospective study was to examine the safety and efficacy of cold polypectomy for sporadic nonampullary duodenal adenomas. Patients and methods Between March 2015 and June 2016, patients who were endoscopically diagnosed with sporadic nonampullary duodenal adenomas up to 6 mm underwent cold polypectomy. Patients with pathologically confirmed adenomas underwent endoscopic biopsy 3 months after resection. The main outcomes of interest were incomplete resection and complications. Results Overall, 39 lesions in 30 patients were removed via cold polypectomy (CFP, 9 lesions in 8 patients; CSP, 30 lesions in 22 patients). Seven of 9 (77.8 %) and 29 of 30 (96.7 %) lesions were removed en bloc via CFP and CSP, respectively. Pathologically, 34 of the 39 lesions (87.2 %) were confirmed as adenomas, and their mean size was 3.9 ± 1.2 mm (range 2 – 6 mm). Of the 34 adenomas, 20 (58.8 %) were R0 resection lesions, of which 3 of 9 (33.3 %) and 17 of 25 (68.0 %) had undergone CFP and CSP, respectively. No delayed bleeding or intraprocedural/delayed perforation was observed. All 30 patients with the 34 pathologically confirmed adenomas underwent upper gastrointestinal endoscopy 3 months after cold polypectomy, and no morphological or pathological recurrence was identified. Conclusions In this small study, cold polypectomy appeared to be safe and effective in treating diminutive and small sporadic nonampullary duodenal adenomas.(Clinical trial registration number: UMIN000016829)

scholarly journals Brunner’s Gland Adenoma – A Rare Cause of Gastrointestinal Bleeding: Case Report and Systematic Review

2017 ◽  
Vol 11 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Michele Sorleto ◽  
Annette Timmer-Stranghöner ◽  
Helge Wuttig ◽  
Oliver Engelhard ◽  
Carsten Gartung 
Keyword(s):  
Systematic Review ◽  
Gastrointestinal Bleeding ◽  
Treatment Options ◽  
Endoscopic Polypectomy ◽  
Upper Gastrointestinal Endoscopy ◽  
Severe Bleeding ◽  
Duodenal Tumor ◽  
Brunner’S Gland ◽  
Brunner's Gland ◽  
Bowel Neoplasm

Brunner’s gland adenoma is an extremely rare benign small bowel neoplasm, often discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics. In few cases, it tends to cause gastrointestinal hemorrhage or intestinal obstruction. We report here our experience with a 47-year-old woman with a Brunner’s gland adenoma of more than 6 cm in size, located in the first part of the duodenum and causing gastrointestinal bleeding. Initially, we performed a partial endoscopic resection using endoloop and snare alternatively to prevent severe bleeding. A rest endoscopic polypectomy with the submucosal dissection technique was planned. However, on request of the patient, an elective surgical duodenotomy with submucosal resection of the remaining small duodenal tumor was performed. To better define the patient’s characteristics and treatment options of such lesions, we performed a systematic review of the available literature in PubMed. Recently, an endoscopic removal is being increasingly practiced and is considered as a safe treatment modality of such lesions.

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