1/9. Giant duodenal diverticulum: presentation by blunt trauma.Most duodenal diverticula are asymptomatic, small (i.e., less than 5 cm in greatest dimension), acquired, extraluminal, and false. The only report of a massive or giant duodenal diverticulum (i.e., 10 cm or more), in the current literature, included severe nocturnal diarrhea. The present case report is the incidental finding of a massive duodenal diverticulum in a 34-year-old male trauma victim. The insidious nature of this case and the patient's age suggest a congenital etiology. We believe this is the first report of such a case.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/9. Giant duodenal gallstone presenting as gastric outlet obstruction: Bouveret's syndrome.In a 91 year old woman with nausea and vomiting, the diagnosis of Bouveret's syndrome was considered when a barium meal disclosed a cholecystoduodenal fistula and a giant filling defect in the duodenum. Because of her age and underlying medical illness, operative therapy was initially deferred. Repeated attempts to remove the intermittently obstructing duodenal gallstone endoscopically were unsuccessful using both endoscopic retrograde cholangiopancreatography retrieval baskets and an endoscopic mechanical lithotripter. The patient was referred for definitive operative therapy, and was discharged after a successful and uneventful enterolithotomy.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/9. "Duodenal intussusception" due to adenoma of the papilla of Vater.The case of a 55-year-old woman with a pedunculate adenoma of the papilla of Vater is presented. diagnostic imaging modalities including ultrasonography, CT scan, magnetic resonance of cholangiopancreatography, simultaneous duodenography and cholangiography, and angiography showed a giant tumor protruding intraluminally and moving forward in the duodenum by peristalsis. It had a duodenal intussusception-like appearance, with remarkable left-lower deviation of the common bile duct and major pancreatic duct in the papilla of Vater as far as the left side of the aorta. Episodes of jaundice or ileus were absent, probably because the tumor was mobile in the duodenum. As biopsy specimens showed no malignancy and intraductal ultrasonography in the common bile duct revealed no intraductal invasion of the tumor in the papilla of Vater, the patient underwent transduodenal papillectomy with papilloplasty with pancreatic ductoplasty. Pathological diagnosis of consecutive specimens was a papillary adenoma with moderate atypia and occasional tubular structure. There seems to be an exceptional subtype of the tumor in the papilla of Vater, like this case, demonstrating the duodenal intussusception-like appearance without prominent clinical symptoms.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/9. Multiple giant duodenal gallstones causing gastric outlet obstruction: Bouveret's minefield revisited.gastric outlet obstruction caused by a gallstone impacted in the duodenum is a rare entity known as Bouveret's syndrome. We report the unusual case of multiple large gallstones impacted in the duodenum from a cholecystoduodenal fistula in an 83-year-old lady. A high index of suspicion allowed for prompt diagnosis. Early surgical intervention was instituted because if the size and number of gallstones with an excellent outcome. The surgical strategies and underlying pitfalls underlying the management of this syndrome are critically reviewed and discussed.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
5/9. Gastrointestinal bleeding as the initial manifestation of a polyarteritis nodosa-associated hepatic artery aneurysm-duodenal fistula--a case report.The authors report an unusual case of upper gastrointestinal bleeding from a hepatic artery aneurysm-duodenal fistula in a 21-year-old male. Arteriography revealed multiple visceral artery aneurysms. biopsy of the hepatic artery aneurysm (HAA) revealed focal areas of necrosis, medial degeneration, fibrosis, and giant cells. The necrotizing vasculitis plus the multiple visceral aneurysms were highly suggestive of polyarteritis nodosa (PAN). This report reviews the pathophysiology and management of PAN and the diagnosis and management of HAA.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/9. Choledochoduodenal fistula from a penetrating duodenal ulcer. A case report.Choledochoduodenal fistula is an uncommon complication of duodenal ulcer disease. The role of medical therapy is unclear and surgical management has been recommended for the condition. A patient who was treated with ranitidine 150 mg twice daily for 8 weeks for a giant duodenal ulcer with a choledochoduodenal fistula is reported. Both the ulcer and the fistula completely healed on medical therapy. Medical therapy may now become the treatment of choice for this condition due to the availability of potent acid-reducing agents.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/9. Acute pancreatitis and upper gastrointestinal bleeding as presenting symptoms of duodenal Brunner's gland hamartoma.Brunner's gland hamartomas are rare, benign small bowel tumours. There were fewer than 150 cases reported in the English literature until the end of the last century. These hamartomas may be discovered incidentally during an upper gastrointestinal tract endoscopy. Otherwise, they may be diagnosed in patients presenting with acute upper gastrointestinal bleeding, anemia or symptoms of intestinal obstruction. The case of a young woman admitted for acute upper gastrointestinal bleeding along with acute pancreatitis is presented. The investigation revealed a giant Brunner's gland hamartoma in the second part of the duodenum. After total endoscopic resection of the tumour, the patient has remained completely asymptomatic for a follow-up period of seven months.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/9. Giant spontaneous duodenal hematoma in hemophilia a.A 12-year-old hemophilic boy was admitted because of acute abdomen with intraabdominal bleeding. The cause was a giant intramural duodenal hematoma that resolved after 16 days of parenteral nutrition. This condition is a rare complication of coagulation disorders, but it should be suspected in cases with internal blood loss. Abdominal ultrasonography, computed tomography scans, and contrast x-ray studies are diagnostic procedures for such cases.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/9. Menetrier's disease: a new variant with duodenal involvement.Menetrier's disease is a rare cause of hypertrophic gastropathy, usually confined to gastric body and fundus, which is characterized by giant rugae, hypoalbuminemia, and foveolar hyperplasia. The etiology of this disease is still unknown. We report a case of a 74-yr-old man who had dyspepsia, hypoalbuminemia, weight loss, and diffuse polypoid, nodular lesions affecting the whole stomach and proximal duodenum on gastroscopy and barium meal study. The histology of gastric and duodenal mucosal lesions fulfilled the diagnosis of Menetrier's disease, that was not described to involve duodenum in the literature. The disease resolved clinically, endoscopically, and pathologically after therapy with famotidine for 3 months. We speculated that extensive pyloric metaplasia and then foveolar hyperplasia of duodenum in this patient might be a variant of Menetrier's disease with favorable clinical course.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |