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Congenital duodenal obstruction in neonates:a decade's experience from one center

World Journal of Pediatrics 2014年第3期10卷 238-244页

作者： Qing-Jiang Chen Zhi-Gang Gao Jin-Fa Tou Yun-Zhong Qian Min-Ju Li Qi-Xing Xiong Qiang Shu Department of Pediatric General Surgery Children's HospitalZhejiang University Shool of MedicineHangzhou 310003China Department of Pediatric Thoracic Surgery Children's HospitalZhejiang University Shool of MedicineHangzhou 310003China

Background:Congenital duodenal obstruction(CDO)is one of the most common anomalies in newborns,and accounting for nearly half of all cases of neonatal intestinal *** study aimed to review our single-center experience in managing congenital duodenal obstruction while evaluate the ***:We conducted a retrospective analysis of the records of all neonates dianogsed with congenital duodenal obstruction admitted to our center between January 2003 and December *** analyzed demographic criteria,clinical manifestations,associated anomalies,radiologic findings,surgical methods,postoperative complications,and fi nal ***:The study comprised 287 newborns(193 boys and 94 girls).Birth weight ranged from 950 g to 4850 ***-three patients were born prematurely between 28 and 36 weeks'*** was diagnosed in 174 patients,annular pancreas in 66,duodenal web in 55,duodenal atresia or stenosis in 9,preduodenal portal vein in 2,and congenital band compression in *** patients had various combinations of these *** symptoms included bilious vomiting,dehydration,and weight loss.X-rays of the upper abdomen demonstrated the presence of a typical double-bubble sign or air-fluid levels in 68.64%of patients,and confi rmatory upper and/or lower gastrointestinal contrast studies were obtained in 64.11%.Multiple associated abnormalities were observed in 50.52%of the *** surgical approaches were used,including Ladd's procedure,duodenoplasty,duodenoduodenostomy,duodenojejunostomy,or a combination of *** patients died postoperatively and 14 required ***:Congenital duodenal obstruction is a complex entity with various etiologies and often includes multiple concomitant *** diagnosis and aggressive surgery are key to improving *** should be taken to address all of the causes of duodenal obstruction and/or associated alimentary tract anomalies during surge

关键词： congenital duodenal obstruction neonate

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duodenal obstruction after successful embolization for duodenal diverticular hemorrhage: A case report

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World Journal of Gastroenterology 2009年第30期15卷 3819-3822页

作者： Yu Jin Kwon Ji Hun Kim Seung Hyoung Kim Bong Soo Kim Heung Up Kim Eun Kwang Choi In Ho Jeong Department of Surgery Seoul National University College of Medicine28 Yeongeon-dongSeoul 110-744South Korea Department of Surgery Ajou University School of MedicineSan-5WonchondongYeongtongguSuwon 442-749South Korea Department of radiology Jeju National University School of Medicine1753-3Ara 1-DongJeju 690-121South Korea Department of internal medicine Jeju National University School of Medicine1753-3Ara 1-DongJeju 690-121South Korea Department of surgery Jeju National University School of Medicine1753-3Ara 1-DongJeju 690-121South Korea

We present a 69-year-old woman with a duodenal obstruction after successful selective transcatheter arterial embolization (TAE) for a duodenal diverticular hemorrhage. Two weeks after TAE, the patient showed abrupt symptoms of duodenal obstruction. Resolving hematomas after successful selective transcatheter arterial embolization should be thoroughly observed because they might result in duodenal fibrotic encasement featuring inflammatory duodenal wall thickening, duodenal deformity, dysmotility, and fi nally obstruction.

关键词： Diverticulum Gastrointestinal hemorrhage Therapeutic embolization duodenal obstruction

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Treating bilio-duodenal obstruction: Combining new endoscopic technique with 6 Fr stent introducer

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World Journal of Gastroenterology 2010年第22期16卷 2828-2831页

作者： Iruru Maetani Tomoko Nambu Shigefumi Omuta Takeo Ukita Hiroaki Shigoka Division of Gastroenterology Department of Internal Medicine Toho University Ohashi Medical Center

Periampullary cancer may cause not only biliary but also duodenal obstructions. In patients with concomitant duodenal obstructions, endoscopic biliary stenting remains technically difficult and may often require percutaneous transhepatic biliary drainage. We describe a method of metal stent placement via a thin forwardviewing endoscope in patients with simultaneous biliary and duodenal obstruction. In two consecutive patients with biliary and duodenal obstruction due to pancreatic cancer, a new biliary metal stent mounted in a slim delivery catheter was placed via a thin forward viewing endoscope after passage across the duodenal stenosis without balloon dilation. In both patients, with our new placement technique, metallic stents were successfully placed in a short time without adverse events. After biliary stenting, one patient received curative resection and the other received duodenal stenting for palliation. Metallic stent placement with a forward-viewing thin endoscope is a beneficial technique, which can avoid percutaneous drainage in patients with bilio-duodenal obstructions due to periampullary cancer.

关键词： Biliary obstruction duodenal obstruction Pancreatic cancer Self-expandable metallic stent Stent placement Thin forward-viewing endoscope

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Malrotation causing duodenal chronic obstruction in an adult

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World Journal of Gastroenterology 2009年第9期15卷 1144-1146页

作者： Jun Gong Zhen-Jiang Zheng Gang Mai Xu-Bao Liu Department of General Surgery West China Hospital Sichuan University Chengdu 610041 Sichuan Province China

Congenital duodenal obstruction is rare in adulthood. An unusual presentation of this condition has led to difficult preoperative *** present a case of proximal jejunal obstruction by a congenital band in an adult and... 详细信息

关键词： Malrotation duodenal obstruction Surgical procedures Congenital band Adult

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Treatment of gastric outlet and duodenal obstructions with uncovered expandable metal stents

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World Journal of Gastroenterology 2007年第40期13卷 5376-5379页

作者： Qiang Huang Ding-Ke Dai Xiao-lun Qian Ren-You Zhai Department of Radiology Beijing Chaoyang Hospital CapitalMedical University Beijing 100021 China

AIM:To investigate and evaluate the technical feasibility and clinical effectiveness of fluoroscopically guided peroral uncovered expandable metal stent placement to treat gastric outlet and duodenal obstructions. METHODS:Fifteen consecutive patients underwent peroral placement of Wallstent^(TM)Enteral Endoprosthesis to treat gastric outlet and duodenal obstructions(14 malignant,1 benign).All procedures were completed under fluoroscopic guidance without endoscopic ***-up was completed until the patients died or were lost,and the clinical outcomes were analyzed. RESULTS:The technique success rate was 100%,and the oral intake was maintained in 12 of 14 patients varying from 7 d to 270 *** patients remained unable to resume oral intake,although their stents were proven to be patent with the barium *** patient with acute necrotizing pancreatitis underwent enteral stenting to treat intestinal obstruction,and nausea and vomiting *** patients died during the follow- up period,and their mean oral intake time was 50 d. No procedure-related complications *** migration to the gastric antrum occurred in one patient 1 year after the procedure,a tumor grew at the proximal end of the stent in another patient 38 d post-stent insertion. CONCLUSION:Fluoroscopically guided peroral metal stent implantation is a safe and effective method to treat malignant gastrointestinal obstructions,and complications can be ignored based on our short-term *** for this procedure should be discreetly considered because a few patients may not benefit from gastrointestinal insertion,but some benign gastrointestinal obstructions can be treated using this procedure.

关键词： Gastric outlet obstruction duodenal obstruction Expandable metal stent

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Post hoc validation of a tool that accurately predicts the outcome of endoscopic therapy in Bouveret syndrome

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Gastroenterology Report 2022年第1期10卷 298-304页

作者： Carla Swift John Ong Man Zhou Benjamin Stokell Yasseen Al-Naeeb Department of Gastroenterology Norwich University HospitalNorwichUK Department of Engineering University of CambridgeCambridgeUK Department of Medicine National University of SingaporeSingapore GKT School of Medical Education King’s College LondonLondonUK Statistical Laboratory Centre for Mathematical SciencesUniversity of CambridgeCambridgeUK Department of Gastroenterology Bedford HospitalBedfordUK

Background Bouveret syndrome is characterized by gallstone impaction in the upper gastrointestinal tract causing gastric outlet *** Bouveret syndrome,endoscopic gallstone removal can avert the need for ***,in cases in which endoscopic therapy is unlikely to succeed,endoscopic attempts delay definitive treatment and compound patient *** previously developed a model that predicts endoscopic outcomes from data derived through a systematic *** tool uses gallstone length,site of impaction,and the number of planned methods of lithotripsy to predict the likelihood of endoscopic success with an accuracy of 81.0%.This study aimed to evaluate our tool performance in an independent,non-training data set and assess endoscopic and surgical *** Systematic searches of the PubMed,Scopus,and Cochrane databases were performed for articles published between 16 April 2018 and 1 June *** data reported after our previous study were harvested and inputted into the tool to evaluate their ability to accurately predict outcomes when compared with actual *** Newly collated data in fields of interest showed no significant statistical differences compared with previous training data *** therapy was successful in 41.9%of *** of ≤4 cm had a higher chance of successful endoscopic intervention(odds ratio 6.7,95%confidence interval 1.7–25.8,P<0.01).Complications of surgery were reported in 29.5%;there was one fatality *** hoc evaluation of our predictive tool demonstrated an AUROC score of *** We have demonstrated in an independent data set that the tool can be used to accurately predict outcomes of endoscopic *** in whom endoscopic therapy is most likely to fail should be offered an early surgical opinion.

关键词： Bouveret syndrome Bouveret’s syndrome gallstone duodenal obstruction gastric outlet obstruction gallstone ileus

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Spontaneous resolution of idiopathic intestinal obstruction after pneumonia: A case report

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World Journal of Clinical Cases 2020年第19期8卷 4512-4520页

作者： Bing-Qing Zhang Xiao-Yan Dai Qiu-Yue Ye Long Chang Zhi-Wei Wang Xiao-Qing Li Yong-Ning Li Internal Medicine Peking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China International Medical Services Peking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Interventional Section Department of RadiologyPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Neurosurgery Peking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China

BACKGROUND duodenal obstruction is a common clinical scenario that can either be mechanical or a *** management of intestinal obstruction starts from localization and proceeds to histological examination of the stenotic *** factors and dysfunction of distant organs might contribute to the development of intestinal ***,we report a unique case of idiopathic mechanical duodenal obstruction,which resolved spontaneously after 3 mo of conservative treatment,but was followed by intestinal *** SUMMARY An 84-year-old woman presented with worsened postprandial vomiting accompanied by prolonged *** noninvasive investigations revealed complete circumferential stenosis in the descending duodenum without known *** surgery was postponed due to septic shock and possible pulmonary fungal *** treatment for 3 mo for ileus and control of pulmonary infection resolved the intestinal obstruction ***,2 wk later,she had regurgitation and postprandial vomiting again,complicated by deteriorating wheezing and *** tomography revealed a dilated stomach and proximal duodenum without new intestinal stricture or pulmonary *** patient fully recovered after combined treatment with antireflux agents,enema,prokinetics,and *** This complicated case highlights the inter-relationship of local and systemic contributions to ileus and gut dysfunction,which requires multidisciplinary treatment.

关键词： duodenal obstruction Pseudo-intestinal obstruction Pneumonia Airway hyperresponsiveness Multidisciplinary treatment Case report

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Clinical characteristics of adult-type annular pancreas:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5722-5728页

作者： Dan Yi Xiao-Bo Ding Shan-Shan Dong Chen Shao Li-Jing Zhao Department of Hepatobiliary and Pancreatic Surgery First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Radiology First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Pathology Beijing You’an HospitalBeijing 100069China Department of Rehabilitation School of NursingJilin UniversityChangchun 130021Jilin ProvinceChina

BACKGROUND Annular pancreas(AP)is a rare congenital abnormal rotation of the *** rarely occurs in *** tumors and ampullary tumors are related to AP,so the discovery and treatment of AP are *** SUMMARY This study investigated the clinical manifestations,imaging features,complications,and treatment of six patients diagnosed with AP at the Department of Hepatobiliary and Pancreatic Surgery,First Hospital of Jilin University from January 2010 to June *** were four males and two females,with an average age of 56.00±9.86 years *** this study,abdominal pain and jaundice were the main clinical *** can show the“crocodile jaw sign”or“double bubble sign”.CONCLUSION For patients with duodenal or biliary obstruction,physicians should give priority to AP when imaging examinations suggest that the duodenum is wrapped with tissue similar to the density of the *** patients should actively undergo surgical treatment.

关键词： Annular pancreas Pancreas/abnormalities Congenital abnormalities Biliary obstruction duodenal obstruction Case report

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Duodenojejunostomy treatment of groove pancreatitis-induced stenosis and obstruction of the horizontal duodenum:A case report

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2945-2953页

作者： Yu Zhang Heng-Hui Cheng Wen-Juan Fan Department of Gastroenterology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Institution of Pathology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina

BACKGROUND Groove pancreatitis(GP)is a rare condition affecting the pancreatic groove region within the dorsal-cranial part of the pancreatic head,duodenum,and common bile *** a rare form of chronic pancreatitis,GP poses a diagnostic and therapeutic challenge for *** is frequently misdiagnosed or not considered;thus,the diagnosis is often delayed by weeks or *** treatment of GP is complicated and often requires surgical intervention,especially *** SUMMARY A 66-year-old man with a history of long-term drinking was admitted to the gastroenterology department of our hospital,complaining of vomiting and acid *** gastrointestinal endoscopy showed luminal stenosis in the descending part of the *** computed tomography showed slight exudation in the descending and horizontal parts of the duodenum with broadening of the groove region,indicating local *** symptoms of intestinal obstruction were not relieved with conservative therapy,and insertion of an enteral feeding tube was not *** laparoscopy was performed and revealed a hard mass with scarring in the horizontal part of the duodenum and *** frozen section analysis showed no evidence of malignancy,and side-to-side duodenojejunostomy was *** pathologic examination showed massive proliferation of fibrous tissue,hyaline change,and the proliferation of spindle *** on the radiologic and pathologic characteristics,a diagnosis of GP was *** patient presented with anastomotic obstruction postoperatively and took a long time to recover,requiring supportive *** GP often involves the descending and horizontal parts of the duodenum and causes duodenal stenosis,impaired duodenal motility,and gastric emptying due to fibrosis.

关键词： Groove pancreatitis duodenal stenosis duodenal obstruction Duodenojejunostomy Case report

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Another new variant of Bouveret's syndrome

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World Journal of Gastroenterology 2009年第3期15卷 378-379页

作者： Seong-Heum Park Sang-Woo Lee Tae-Jin Song Department of Surgery Korea UniversityAnsan Hospital516Gojan-dongDanwon-guAnsanGyeonggi-do 425-707South Korea Department of Gastroenterology Korea UniversityAnsan Hospital516Gojan-dongDanwon-guAnsanGyeonggi-do 425-707South Korea

Although Bouveret's syndrome,*** outlet obstruction by a large gallstone impacted in the proximal duodenum secondary to a cholecystoduodenal fistula,is rare,its pathogenesis and clinical features are well ***,existence of variant forms of the syndrome are not well known,and as far as we know,only two cases of variant Bouveret's syndrome have been described in the English-language *** present a case of another new variant of Bouveret's syndrome in a 54-year-old Korean woman.

关键词： duodenal obstruction Biliary fistula Gallstones

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