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Endoscopic treatment of duodenal fistula after incomplete closure of ERCP-related duodenal perforation

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World Journal of Gastrointestinal Endoscopy 2014年第6期6卷 260-265页

作者： Dong Wook Yu Man Yong Hong Seung Goun Hong Department of Internal Medicine SAM Anyang Hospital

Endoscopic retrograde cholangiopancreatography(ERCP)is an important diagnostic and therapeutic modality for various pancreatic and biliary *** most common ERCP-induced complication is pancreatitis,whereas hemorrhage,cholangitis,and perforation occur less *** recognition and prompt treatment of these complications may minimize the morbidity and *** of the most serious complications is *** the incidence of duodenal perforation after ERCP has decreased toduodenal ulcers,or *** causative factors include Crohn's disease,trauma,pancreatitis,and *** majority of duodenal fistulas heal with nonoperative *** that fail to heal are best treated with *** proposed endoscopic approaches for managing gastrointestinal leaks caused by fistulas include fibrin glue injection and positioning of *** patient developed a secondary persistent duodenal fistula as a result of previous incomplete closure of duodenal perforation with hemoclips and an *** fistula was successfully repaired by additional clipping and fibrin glue injection.

关键词： Perforation duodenal Endoscopic retrograde cholangiopancreatography Fistula Glue

Massive duodenal variceal bleed; complication of extra hepatic portal hypertension: Endoscopic management and literature review

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2015年第4期6卷 248-252页

作者： Christopher Steevens Maisa Abdalla Truptesh H Kothari Vivek Kaul Shivangi Kothari Division of Gastroenterology and Hepatology Center for Advanced Therapeutic Endoscopy University of Rochester Medical Center Developmental Endoscopy Lab at UR Division of Gastroenterology and Hepatology Center for Advanced Therapeutic Endoscopy University of Rochester Medical Center

Bleeding from duodenal varices is reported to be a catastrophic and often fatal event. Most of the cases in the literature involve patients with underlying cirrhosis. However, approximately one quarter of duodenal variceal bleeds is caused by extrahepatic portal hypertension and they represent a unique population given their lack of liver dysfunction. The authors present a case where a 61-year-old male with history of remote crush injury presented with bright red blood per rectum and was found to have bleeding from massive duodenal varices. Injection sclerotherapy with ethanolamine was performed and the patient experienced a favorable outcome with near resolution of his varices on endoscopic follow-up. The authors conclude that sclerotherapy is a reasonable first line therapy and review the literature surrounding the treatment of duodenal varices secondary to extrahepatic portal hypertension.

关键词： Extrahepatic portal hypertension duodenal varices

Alobar Holoprosencephaly with duodenal Atresia: A Case Report

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Open Journal of Obstetrics and Gynecology 2019年第8期9卷 1189-1196页

作者： Wiryawan Permadi D. Setiawan M. Alamsyah Aziz Yanuarman Anita D. Anwar F. F. Wirakusumah Obstetrics and Gynecology Department Faculty of Medicine Padjadjaran University Hasan Sadikin Hospital Bandung West Java Indonesia

Introduction: Holoprosencephaly (HPE) is the most frequent malformation of the prosencephalon. It represents the absence or incomplete division of the prosencephalon during the 4th and 8th week of gestation. Its incidence is estimated to be 1 in 16,000 live births and 1 in 250 spontaneous abortions. According to the degree of cerebral involvements, it is classified into 3 types: alobar, semilobar, and lobar. Alobar is the most severe type. duodenal atresia occurs in approximately 1:10,000 live births. It can be fatal unless diagnosed and surgically treated promptly. It is a less common cause of polyhydramnion. The diagnosis of duodenal obstruction may be suspected prior to the child’s birth by prenatal ultrasonography. The outcome of congenital duodenal obstructions, in terms of mortality rate, has improved over the last decades, mainly attributable to the improvement in the quality of prenatal diagnosis and neonatal intensive care. Embryological basis for etiology of duodenal atresia is thought to be due to errors of recanalization. duodenal atresia is associated with other congenital anomalies in spite with holoprosencephaly. This is the only case (HPE with duodenal atresia) which is reported in Hasan Sadikin Hospital in the last five years. Materials and Methods: A patient G2P1A0 who had vaginal birth 6 years ago, without complication on mother and fetus was referred to Hasan Sadikin Hospital with abdominal discomfort as main complaint on her 33 - 34 weeks of pregnancy. Prenatal care was during the first and second trimester by midwife and sonography in satellite hospital. She had polyhydramnion and head abnormality and referred to Hasan Sadikin Hospital. Sonography examination showed alobar holoprosencephaly, abnormal facial (cleft lip and palate, absent nasal bone, hypotelorism), duodenal atresia and polyhydramnios (Amniotic Fluid Index 50 cm);other examinations were normal. Amnioreduction and karyotyping examination were done. After 3 weeks the amniotic fluid

关键词： Holoprosencephaly duodenal Atresia Ultrasound Examination

Future directions of duodenal endoscopic submucosal dissection

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World Journal of Gastrointestinal Endoscopy 2015年第4期7卷 389-395页

作者： Satohiro Matsumoto Hiroyuki Miyatani Yukio Yoshida Department of Gastroenterology Saitama Medical CenterJichi Medical University

Endoscopic therapies for lesions of the duodenum are technically more difficult than those for lesions of the other parts of the gastrointestinal tract due to the anatomical features of the duodenum, and the incidence rate of complications such as perforation and bleeding is also higher. These aforementioned trends were especially noticeable for the case of duodenal endoscopic submucosal dissection(ESD). The indication for ESD of duodenal tumors should be determined by assessment of the histopathology, macroscopic morphology, and diameter of the tumors. The three types of candidate lesions for endoscopic therapy are adenoma, carcinoma, and neuroendocrine tumors. For applying endoscopic therapies to duodenal lesions, accurate preoperative histopathological diagnosis is necessary. The most important technical issue in duodenal ESD is the submucosal dissection process. In duodenal ESD, a short needle-type knife is suitable for the mucosal incision and submucosal dissection processes, and the Small-caliber-tip Transparent hood is an important tool. After endoscopic therapies, the wound should be closed by clipping in order to prevent complications such as secondary hemorrhage and delayed perforation. At present, the criteria for selection between ESD and EMR vary among institutions. The indications for ESD should be carefully considered. duodenal ESD should have limitations, such as the need for its being performed by experts with abundant experience in performing the procedure.

关键词： duodenal tumor Endoscopic submucosaldissection Cancer Adenoma Neuroendocrine tumor Technical know-how Complication Endoscopic mucosalresection

Endoscopic diagnosis and treatment of superficial nonampullary duodenal tumors

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World Journal of Gastrointestinal Endoscopy 2018年第9期10卷 156-164页

作者： Mitsuru Esaki Sho Suzuki Hisatomo Ikehara Chika Kusano Takuji Gotoda Division of Gastroenterology and Hepatology Department of MedicineNihon University School of Medicine

The diagnostic and treatment guidelines of superficial non-ampullary duodenal tumors have not been standardized due to their low *** reports suggested that a superficial adenocarcinoma(SAC) should be treated via local resection because of its low risk of lymph node metastasis,whereas a highgrade adenoma(HGA) should be resected because of its high risk of progression to ***,pretreatment diagnosis of SAC or HGA is important to determine the appropriate treatment *** are certain endoscopic features known to be associated with SAC or HGA,and current practice prioritizes the endoscopic and biopsy diagnosis of these *** treatment of these duodenal lesions is often related to high risk of morbidity,and therefore endoscopic resection has become increasingly common in recent *** mucosal resection(EMR) and endoscopic submucosal dissection(ESD) are the commonly performed endoscopic resection *** is preferred due to its lower risk of adverse events;however,it has a higher risk of recurrence than ***,a new and safer endoscopic procedure that reduces adverse events from EMR or ESD has been reported.

关键词： Endoscopic resection Endoscopic mucosal resection Superficial non-ampullary duodenal tumor Endoscopic submucosal dissection Closure

Annular pancreas producing duodenal obstruction: A case report

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Open Journal of Gastroenterology 2013年第3期3卷 202-204页

作者： Abdesslam Bouassria Hicham Elbouhaddouti Ouadii Mouaqit El Bachir Benjelloun Abdelmalek Ousadden Khalid Mazaz Khalid Ait Taleb Department of General Surgery “A” University Hospital Hassan II Fez Morocco Department of General Surgery “B” University Hospital Hassan II Fez Morocco

Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the duodenum. This malformation is usually asymptomatic in adults, but can manifests as pancreatitis, duodenal stenosis, or duodenal or gastric ulceration. We report the case of a young patient of 18 years old hospitalized for epigastric pain and vomiting, in whom radiological investigations showed an annular pancreas. At operation, a complete obstruction of the duodenum between its first and second parts was found, caused by an annular pancreas. No other congenital anomaly of the intra abdominal organs was noted. A gastroenterostomy was performed. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation.

关键词： Annular Pancreas duodenal Stenosis Gastroenterostomy

Life threatening bleeding from duodenal ulcer after Roux-en-Y gastric bypass: Case report and review of the literature

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World Journal of Gastrointestinal Endoscopy 2014年第12期6卷 625-629页

作者： Arpad Ivanecz Marko Sremec Davorin erani Stojan Potr Pavel Skok Department of Abdominal and General Surgery University Medical Center Maribor Faculty of Medicine University of Maribor Department of Gastroenterology University Medical Center Maribor

Acute upper gastrointestinal bleeding is a rare, but serious complication of gastric bypass surgery. The inaccessibility of the excluded stomach restrains postoperative examination and treatment of the gastric remnant and duodenum, and represents a major challenge, especially in the emergency setting. A 59-year-old patient with previous history of peptic ulcer disease had an upper gastrointestinal bleeding from a duodenal ulcer two years after having a gastric bypass procedure for morbid obesity. After negative upper endoscopy finding, he was urgently evaluated for gastrointestinal bleeding. At emergency laparotomy, the bleeding duodenal ulcer was identified by intraoperative endoscopy through gastrotomy. The patient recovered well after surgical hemostasis, excision of the duodenal ulcer and completion of the remnant gastrectomy. Every general practitioner, gastroenterologist and general surgeon should be aware of growing incidenceof bariatric operations and coherently possible complications after such procedures, which modify patient's anatomy and physiology.

关键词： Roux-en-Y gastric bypass duodenal ulcer Bleeding Endoscopy Emergency surgery

Quadruple regimens using domestically manufactured drugs in gastritis and duodenal ulcer patients for Helicobacter pylori eradication:a perspective,multicenter,randomized controlled trial

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China Medical Abstracts(Internal Medicine) 2016年第1期33卷 41-42页

作者：高文 Dept Gastrointest Peking Univ 1st Hosp

Objective To observe the effects and safety of quadruple regimens including domestically manufactured rabeprazole used as first line/initial therapy for Helicobacter pylori(***)eradication in gastritis and duodenal ul... 详细信息

关键词： gastritis duodenal manufactured bismuth completed citrate regimen breath mycin vomiting

Small bowel perforation after duodenal stent migration:An interesting case of a rare complication

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World Journal of Radiology 2011年第6期3卷 152-154页

作者： Peter HU Lee Robert Moore Akshay Raizada Richard Grotz Department of Surgery Tufts University School of MedicineSt.Elizabeth's Medical CenterBostonMA 02135United States Department of Surgery David Geffen School of Medicine at UCLARonald Regan UCLA Medical CenterLos AngelesCA 90095United States Department of Surgery University of Massachusetts Medical SchoolUMass Memorial Medical CenterWorcesterMA 01655United States Department of Internal Medicine Kaiser Permanente Medical CenterSan FranciscoCA 94115United States Department of Surgery Tufts University School of MedicineGood Samaritan Medical CenterBrocktonMA 02301United States

duodenal stents are frequently used for palliating malignant gastric outlet *** stent placement relieves obstructive symptoms,is cost effective,and has a relatively low complication ***,enteral stents have the potential of migrating distally and rarely,even lead to bowel *** present a rare case of a duodenal stent placed as a palliative measure for gastric outlet obstruction due to unresectable pancreatic cancer that migrated distally after a gastrojejunostomy resulting in small bowel perforation.

关键词： Small bowel perforation Gastrojejunostomy Stent migration duodenal stent Pancreatic cancer Gastric outlet obstruction