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World Journal of Clinical Cases 2018年第16期6卷 1217-1222页

作者： Bu-Shan Xie Jia-Wei Zhong An-Jiang Wang Zhen-Dong Zhang Xuan Zhu Gui-Hai Guo Department of Gastroenterology the First Affiliated Hospital of Nanchang University Department of Pathology the First Affiliated Hospital of Nanchang University

BACKGROUND duodenal varices are a lesser-known complication with non-cirrhotic portal hypertension. We report a circuitous route from missed diagnosis of duodenal varices to correction. An extremely rare case of duodenal variceal bleeding secondary to idiopathic portal hypertension(IPH) is expounded in this study, which was controlled by transjugular intra-hepatic porto-systemic shunt(TIPS) plus embolization. CASE SUMMARY A 46-year-old woman with anemia for two years was frequently admitted to the local hospital. Upon examination, anemia was attributed to gastrointestinal tract bleeding, which resulted from duodenal variceal bleeding detected by repeated esophagogastroduodenoscopy. At the end of a complete workup, IPH leadingto duodenal varices was diagnosed. Portal venography revealed that the remarked duodenal varices originated from the proximal superior mesenteric vein. TIPS plus embolization with coils and Histoacryl was performed to obliterate the rupture of duodenal varices. The anemia resolved, and the duodenal varices completely vanished by 2 mo after the initial operation. CONCLUSION TIPS plus embolization may be more appropriate to treat the bleeding of large duodenal varices.

关键词： Idiopathic portal hypertension Anemia duodenal variceal bleeding Transjugular intra-hepatic porto-systemic shunt Embolization Case report

duodenal mature teratoma causing partial intestinal obstruction:A first case report in an adult

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World Journal of Clinical Cases 2020年第8期8卷 1489-1494页

作者： Tharintorn Chansoon Napat Angkathunyakul Rangsima Aroonroch Jakrapan Jirasiritham Department of Pathology Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok 10400Thailand Department of Surgery Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok 10400Thailand

BACKGROUND A teratoma is a germ cell tumor that is composed of tissue derived from two or three germ *** teratomas are extremely rare and have been exclusively reported in neonates and *** is the third case of a teratoma primarily arising in the duodenum and the first case that occurred in an *** SUMMARY A 31-year-old male presented with clinical partial gut obstruction(epigastric pain,nausea,and vomiting).The physical examination showed a palpable illdefined mass on the left side of the *** computed tomography scan revealed a multiseptated cystic tumor at the retroperitoneal ***,he underwent gastrojejunostomy to relieve the symptoms and was referred to a tertiary-care *** second operation revealed a 10-cm solid-cystic mass originating from the third part of the duodenum and adhering to the abdominal aorta and *** duodenectomy was *** pathological diagnosis was a mature cystic *** patient was asymptomatic at 5 mo after the *** duodenal teratomas are extremely rare but should be included in the differential diagnosis in patients who present with intestinal *** imaging is helpful to reach the preoperative *** team planning is essential to avoid injury to the adjacent organ in duodenal operation.

关键词： duodenal teratoma Mature cystic teratoma Intestinal obstruction Germ cell tumor Retroperitoneal mass Case report

Clinicopathological evaluation of duodenal well-differentiated endocrine tumors

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World Journal of Gastroenterology 2010年第36期16卷 4583-4588页

作者： Kenji Ishido Satoshi Tanabe Katsuhiko Higuchi Tohru Sasaki Chikatoshi Katada Mizutomo Azuma Akira Naruke Wasaburo Koizumi Tetsuo Mikami Department of Gastroenterology Kitasato University East Hospital2-1-1 AsamizodaiMinami-kuSagamiharaKanagawa 252-0380Japan Department of Pathology Kitasato University East Hospital2-1-1 AsamizodaiMinami-kuSagamiharaKanagawa 252-0380Japan

AIM:To assess the clinicopathological characteristics of duodenal well-differentiated endocrine ***:We examined clinicopathological characteristics in 11 consecutive patients with duodenal well-differentiated endocrine tumors treated by endoscopic therapy or surgery in our hospital from 1992 through *** with well-differentiated endocrine tu-mors of the papilla of Vater or with gastrinoma were ***:Three patients received endoscopic treatment,and 8 underwent *** patients who received endoscopic treatment,the tumor diameter was less than 1.0 cm,with no histopathological evidence of lymphovascular invasion or invasion of the *** were no complications such as late bleedingor perforation after *** 8 patients with tumors less than 1.0 cm in diameter,3 underwent partial resection,and 2 underwent radical *** patients had lymphovascular invasion,1 had invasion of the muscularis,and 1 had proximal lymph node *** 3 patients with tumors 1.0 cm or more in diameter,1 underwent partial resection,and 2 under-went radical *** patient had lymphovascular invasion,with no lymph node *** treatment,all patients are alive and have remained free of metastasis and ***:duodenal well-differentiated endocrine tumors less than 1.0 cm in diameter have a risk of lym-phovascular invasion,invasion of the muscularis,and lymph node metastasis,irrespective of procedural prob-lems.

关键词： duodenal well-differentiated endocrine tumors Endoscopic resection Surgical operation

duodenal intussusception secondary to ampullary adenoma: A case report

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World Journal of Clinical Cases 2019年第14期7卷 1857-1864页

作者： Masaaki Hirata Yoshiharu Shirakata Kenya Yamanaka Department of Surgery Hyogo Prefectural Amagasaki General Medical CenterAmagasakiHyogo 660-0892Japan

BACKGROUND Because the duodenum is fixed onto the retroperitoneum, duodenal intussusception is usually impossible except in cases of malrotational abnormality. Although cases of duodenal intussusception without malrotational abnormalities have been reported, it is unclear whether they constitute true intussusception or simple mucosal prolapse. CASE SUMMARY A 66-year-old woman presented with whole-body edema and malaise. Blood analysis indicated severe anemia and cholestasis. Endoscopic examination revealed a pedunculate polyp on the second part of the duodenum that migrated distally with mucosal elongation. Computed tomography showed duodenal intussusception. A tumor as the lead point and retroperitoneal structure, including the head of the pancreas and fat, invaginated beyond the duodenojejunal flexure. She was diagnosed with ampullary adenoma caused repeated intussusception that reduced spontaneously and underwent pancreaticoduodenectomy. Laparotomy showed tumor prolapse beyond the duodenojejunal flexure without intussusception. There was no evidence of malrotational abnormality. She was discharged with no complications. CONCLUSION We report true duodenal intussusception without malrotational abnormality. This phenomenon was also associated with mucosal prolapse.

关键词： duodenal intussusception Mucosal prolapse Ampullary adenoma Case report

Successful endovascular treatment of endoscopically unmanageable hemorrhage from a duodenal ulcer fed by a renal artery: A case report

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World Journal of Clinical Cases 2018年第15期6卷 1012-1017页

作者： Shimpei Anami Hiroki Minamiguchi Naoaki Shibata Takao Koyama Hirotatsu Sato Akira Ikoma Motoki Nakai Takuji Yamagami Tetsuo Sonomura Department of Radiology Wakayama Medical University Department of Radiology Kochi Medical School Kochi University Department of Emergency and Critical Care Medicine Wakayama Medical University

A 52-year-old woman was admitted with hypovolemic shock. Emergency endoscopy revealed three hemorrhagic duodenal ulcers(all stage A1) with exposed vessels. Two ulcers were successfully treated by endoscopic clipping; however, the remaining ulcer on the posterior wall of the horizontal portion of the duodenum could not be clipped. Because her vital signs were rapidly worsening, we performed transcatheter arterial embolization(TAE) as it is less invasive than surgery. Computed tomography aortography showed that the duodenal hemorrhage was sourced from the lower branch of the right renal artery. In general, the duodenum is fed by branches from the gastroduodenal artery or superior mesenteric artery. However, this patient had three right renal arteries. The lower branch of the right renal artery at the L3 vertebral level was at the same level as the horizontal portion of the duodenum. Complete hemostasis was achieved by TAE using metallic coils and n-butyl-2-cyanoacrylate. After TAE, she recovered from the hypovolemic shock and was discharged from hospital. She has had no recurrence of the hemorrhagic duodenal ulcer for over 1 yr, and followup endoscopy showed no necrosis or stricture of the duodenum. Although she developed a small infarct of her right kidney, her renal function was satisfactory. In summary, the present case is the first reported case of hemorrhagic duodenal ulcer in which the culprit vessel was a renal artery that was successfully treated by TAE. Computed tomography aortography before TAE provides valuable information regarding the source of a duodenal hemorrhage.

关键词： Transcatheter arterial embolization Metallic coils N-butyl-2-cyanoacrylate Renal artery Emergency radiology Case report duodenal ulcer

Eviendep~ reduces number and size of duodenal polyps in familial adenomatous polyposis patients with ileal pouchanal anastomosis

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World Journal of Gastroenterology 2013年第34期19卷 5671-5677页

作者： Carlo Calabrese Chiara Praticò Andrea Calafiore Maurizio Coscia Lorenzo Gentilini Gilberto Poggioli Paolo Gionchetti Massimo Campieri Fernando Rizzello Dipartimento di Scienze Mediche e Chirurgiche (DIMEC) University of Bologna

AIM:To evaluate if 3 mo oral supplementation with Eviendep was able to reduce the number of duodenal polyps in familial adenomatous polyposis(FAP)patients with ileal pouch-anal anastomosis(IPAA).METHODS:Eleven FAP patients with IPAA and duodenal polyps were *** underwent upper gastrointestinal(GI)endoscopy at the baseline and after 3 mo of *** patient received 5 mg Eviendep twice a day,at breakfast and dinner time,for3 *** endoscopists evaluated in a blinded manner the number and size of duodenal *** GI endoscopies with biopsies were performed at the baseline(T0)with the assessment of the Spigelman ***>10 mm were removed during endoscopy and at the end of the procedure a new Spigelman score was determined(T1).The procedure was repeated 3 mo after the baseline(T2).Four photograms were examined for each patient,at T1 and *** examined area was divided into 3 segments:duodenal bulb,second and third portion *** specimens were taken from all polyps>10 mm and from all suspicious ones,defined by the presence of a central depression,irregular surface,or irregular vascular *** was classified according to the updated Vienna ***:At baseline the mean number of duodenal detected polyps was 27.7 and mean sizes were 15.8mm;the mean Spigelman score was *** polypectomy the mean number of duodenal detected polyps was 25.7 and mean sizes were 7.6 mm;the mean Spigelman score was *** 3 mo of Eviendep bid,all patients showed a reduction of number and size of duodenal *** mean number of duodenal polyps was 8(P=0.021)and mean size was 4.4 mm;the mean Spigelman score was *** agreement was ***>1 cm found a very good degree of concordance(kappa 0.851)and a good concordance was as well encountered for smaller lesions(kappa 0.641).CONCLUSION:Our study demonstrated that shortterm(90 d)supplementation with Eviendep in FAP patients with IPAA and with recurrent adenomas in t

关键词： Familial adenomatous polyposis Ileal pouch-anal anastomosis duodenal polyps Eviendep

Gastro-duodenal disease in Africa: Literature review and clinical data from Accra, Ghana

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World Journal of Gastroenterology 2019年第26期25卷 3344-3358页

作者： Timothy N Archampong Richard H Asmah Cathy J Richards Vicki J Martin Christopher D Bayliss Edília Botao Leonor David Sandra Beleza Carla Carrilho Department of Medicine and Therapeutics School of Medicine and DentistryUniversity of GhanaAccra Box 4236Ghana Department of Genetics and Genome Biology University of LeicesterLeicester LE1 7RHUnited Kingdom Department of Medical Laboratory Sciences School of Biomedical and Allied Health SciencesUniversity of GhanaAccra Box 4236Ghana Department of Histopathology Leicester Royal InfirmaryLeicester LE1 5WWUnited Kingdom Department of Pathology Maputo Central HospitalMaputo POBox 1164Mozambique Department of Pathology Medical Faculty of the University of PortoPorto 4200-465Portugal Institute of Molecular Pathology and Immunology at the University of Porto(Ipatimup) Porto 4200-465Portugal Instituto de Investigacao e Inovacao em Saude(i3S) University of PortoPorto 4200-465Portugal Department of Pathology Faculty of MedicineEduardo Mondlane UniversityMaputo POBox 257Mozambique

Gastroduodenal disease(GDD)was initially thought to be uncommon in *** others,lack of access to optimal health infrastructure and suspicion of conventional medicine resulted in the reported prevalence of GDD being significantly lower than that in other areas of the *** the increasing availability of flexible upper gastro-intestinal endoscopy,it has now become apparent that GDD,especially peptic ulcer disease(PUD),is prevalent across the continent of *** risk factors for gastric cancer(GCA)include Helicobater pylori(***),diet,Epstein-Barr virus infection and industrial chemical exposure,while those for PUD are ***,non-steroidal antiinflammatory drug(NSAID)-use,smoking and alcohol *** these,*** is generally accepted to be causally related to the development of atrophic gastritis(AG),intestinal metaplasia(IM),PUD and distal ***,we perform a systematic review of the patterns of GDD across Africa obtained with endoscopy,and complement the analysis with new data obtained on premalignant gastric his-topathological lesions in Accra,Ghana which was compared with previous data from Maputo,*** there is a general lack of structured cohort studies in Africa,we also considered endoscopy-based hospital or tertiary centre studies of symptomatic *** Africa,there is considerable heterogeneity in the prevalence of PUD with no clear geographical ***,there are differences in PUD within-country despite universally endemic *** *** is not uncommon in *** of the African tertiary-centre studies had higher prevalence of PUD when compared with similar studies in western *** additional intriguing observation is a recent,ongoing decline in PUD in some African countries where *** infection is still *** possible reason for the high,sustained prevalence of PUD may be the significant use of NSAIDs in local or over-the-counter *** prevalence

关键词： Gastroduodenal Peptic ulcer Gastric cancer Africa Pre-malignant Atrophy Intestinal metaplasia duodenal ulcer Gastric ulcer

Bypassing major venous occlusion and duodenal lesions in rats, and therapy with the stable gastric pentadecapeptide BPC 157, L-NAME and L-arginine

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World Journal of Gastroenterology 2018年第47期24卷 5366-5378页

作者： Fedor Amic Domagoj Drmic Zdenko Bilic Ivan Krezic Helena Zizek Marina Peklic Robert Klicek Alen Pajtak Enio Amic Tinka Vidovic Mislav Rakic Marija Milkovic Perisa Katarina Horvat Pavlov Antonio Kokot Ante Tvrdeic Alenka Boban Blagaic Mario Zovak Sven Seiwerth Predrag Sikiric Department of Pharmacology Medical Faculty University of Zagreb Department of Pathology Medical Faculty University of Zagreb

AIM To investigate whether duodenal lesions induced by major venous occlusions can be attenuated by BPC 157 regardless nitric oxide(NO) system *** Male Wistar rats underwent superior anterior pancreaticoduodenal vein(SAPDV)-ligation and were treated with a bath at the ligated SAPDV site(BPC 157 10 μg, 10 ng/kg per 1 mL bath/rat; L-NAME 5 mg/kg per 1 m L bath/rat; L-arginine 100 mg/kg per 1 mL bath/rat, alone and/or together; or BPC 157 10 μg/kg instilled into the rat stomach, at 1 min ligation-time). We recorded the vessel presentation(filled/appearance or emptied/disappearance) between the 5 arcade vessels arising from the SAPDV on the ventral duodenum side, the inferior anterior pancreaticoduodenal vein(IAPDV) and superior mesenteric vein(SMV) as bypassing vascular pathway to document the duodenal lesions presentation; increased NO-and oxidative stress [malondialdehyde(MDA)]-levels in *** Unlike the severe course in the SAPDV-ligated controls, after BPC 157 application, the rats exhibited strong attenuation of the mucosal lesions and serosal congestion, improved vessel presentation, increased interconnections, increased branching by more than 60% from the initial value, the IAPDV and SMV were not congested. Interestingly, after 5 min and 30 min of L-NAME and L-arginine treatment alone, decreased mucosal and serosal duodenal lesions were observed; their effect was worsened at 24 h, and no effect on the collateral vessels and branching was seen. Together, L-NAME+L-arginine antagonized each other's response, and thus, there was an NO-related effect. With BPC 157, all SAPDV-ligated rats receiving L-NAME and/or L-arginine appeared similar to the rats treated with BPC 157 alone. Also, BPC 157 in SAPDV-ligated rats normalized levels of NO and MDA, two oxidative stress markers, in duodenal *** BPC 157, rapidly bypassing occlusion, rescued the original duodenal flow through IAPDV to SMV flow, aneffect related to the NO system and

关键词： Major venous occlusion duodenal lesions BPC 157 L-NAME Bypassing L-arginine Reduction of free radical formation Rats

Preoperative endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors, including magnifying endoscopy

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World Journal of Gastroenterology 2015年第41期21卷 11832-11841页

作者： Shigetsugu Tsuji Hisashi Doyama Kunihiro Tsuji Sho Tsuyama Kei Tominaga Naohiro Yoshida Kenichi Takemura Shinya Yamada Hideki Niwa Kazuyoshi Katayanagi Hiroshi Kurumaya Toshihide Okada Department of Gastroenterology Ishikawa Prefectural Central Hospital Kanazawa Department of Diagnostic Pathology Ishikawa Prefectural Central Hospital Kanazawa

Superficial non-ampullary duodenal epithelial tumor(SNADET) is defined as a sporadic tumor that is confined to the mucosa or submucosa that does not arise from Vater's papilla, and it includes adenoma a n d a d e n o c a r c i n o m a. R e c e n t d e v e l o p m e n t s i n endoscopic technology, such as high-resolution endoscopy and image-enhanced endoscopy, may increase the chances of detecting SNADET lesions. However, because SNADET is rare, little is known about its preoperative endoscopic diagnosis. The use of endoscopic resection for SNADET, which has no risk of metastasis, is increasing, but the incidence of complications, such as perforation, is significantly higher than in any other part of the digestive tract. A preoperative diagnosis is required to distinguish between lesions that should be followed up and those that require treatment. Retrospective studies have revealed certain endoscopic findings that suggest malignancy. In recent years, several new imaging modalities have been developed and explored for realtime diagnosis of these lesion types. Establishing an endoscopic diagnostic tool to differentiate between adenoma and adenocarcinoma in SNADET lesions is required to select the most appropriate treatment. This review describes the current state of knowledge about preoperative endoscopic diagnosis of SNADETs, such as duodenal adenoma and duodenal adenocarcinoma. Newer endoscopic techniques, including magnifying endoscopy, may help to guide these diagnostics, but their additional advantages remain unclear, and further studies are required to clarify these issues.

关键词： Endoscopy Duodenoscopy duodenal neoplasms Narrow b

The relation between HLA-DQA1 genes and genetic susceptibility to duodenal ulcer in Wuhan Hans

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World Journal of Gastroenterology 2000年第1期6卷 107-110页

作者： Du YP Deng CS Lu DY Huang MF Guo SF Hou W Department of Gastroenterology the Second Affiliated HospitalHubei Medical UniversityWuhan 430071Hubei ProvinceChina Department of Clinical Cancer Institute of Virus Research of Basic MedicineHubei Medical UniversityWuhan 430071Hubei ProvinceChina

AIM To study the genetic susceptibility of HLA-DQA1 alleles to duodenal ulcer in Wuhan *** Seventy patients with duodenalulcer and fifty healthy controls were examinedfor HLA-DQA1 ***-DQA1 typing wascarried out by digesting the locus specificpolymerase chain reaction amplified productswith alleles specific restriction enzymes(PCR-RFLP),i.e.,Apal Ⅰ,Bsaj Ⅰ,Hph Ⅰ,Fok Ⅰ,Mbo Ⅱ and Mnl Ⅰ.RESULTS The allele frequencies of DQA1 * 0301and DQA1 * 0102 in patients with duodenal ulcerwere significantly higher and lower respectivelythan those in healthy controls(0.40 vs 0.20,P = 0.003,mcorret = 0.024)and(0.05 vs 0.14,P = 0.012,but Pcorret>0.05),*** DQA1 * 0301 is a susceptiblegene for duodenal ulcer in Wuhan Hans,andthere are immunogenetic differences in HLA-DQA1 locus between duodenal ulcer patients andhealthy controls.

关键词： Subject headings duodenal ulcer HLA-DQA1 gene polymerase chain reaction restricted fragment length polymorphism genetic susceptibility