1/284. Studies on the functional disturbances of the papillary region using a pressure sensor.Investigation of the duodenal papilla and the bile duct by EPCG is essential to diagnose the organic and functional disturbances of the papillary region. We have developed a pressure sensor based on a semi-conductor in order to obtain a more objective observation of pathological conditions in the papillary region. Using a duodenofiberscope, the pressure sensor was placed on the tip of canula, and it was inserted into the papilla and measured the movements of the papillary region. The pressure sensor method was carried out in 18 normal subjects and 69 patients with various diseases. As the result of analysis of wave forms in normal subjects, regular wave form patterns were obtained. In about 71% of cases with biliary diseases irregular wave forms were observed. Irregular wave form patterns were also observed 40% of cases with cholecystolithiasis, while irregular patterns were revealed in 86% cases with choledocholithiasis. The pressure sensor method during for duodenofiberscopy is important diagnostic procedure for the determination of functional disturbances in the papillary region.- - - - - - - - - - ranking = 1keywords = bile duct, bile, duct (Clic here for more details about this article) |
2/284. Definitive diagnosis of intestinal volvulus in utero.Midgut volvulus with or without intestinal malrotation can occur in fetal life. Several reports have described congenital midgut volvulus showing non-specific sonographic findings of intestinal obstruction and perforation in utero. None of the previously reported cases, however, were definitively diagnosed as midgut volvulus by fetal sonography. We report two cases both exhibiting the sonographic 'whirlpool' sign, in utero. color Doppler interrogation provided a clue to the viability of the involved intestinal segment.- - - - - - - - - - ranking = 0.94372737721961keywords = obstruction (Clic here for more details about this article) |
3/284. Laparoscopic drainage of an intramural duodenal hematoma.A 21-year-old man was admitted with vomiting and abdominal pain 3 days after sustaining blunt abdominal trauma by being tackled in a game of American football. A diagnosis of intramural hematoma of the duodenum was made using computed tomography and upper gastrointestinal tract contrast radiography. The hematoma caused obstructive jaundice by compressing the common bile duct. The contents of the hematoma were laparoscopically drained. A small perforation was then found in the duodenal wall. The patient underwent laparotomy and repair of the injury. Laparoscopic surgery can be used as definitive therapy in this type of abdominal trauma.- - - - - - - - - - ranking = 0.93066484371357keywords = bile duct, bile, duct (Clic here for more details about this article) |
4/284. Gastroduodenal intussusception secondary to a gastric carcinoma.A case of gastroduodenal intussusception secondary to transpyloric prolapse of a primary gastric carcinoma is reported. Both the condition itself and the leading tumor, gastric carcinoma, are extremely exceptional. A diagnosis of this rare entity was established pre-operatively by endoscopy that demonstrated spontaneous reduction of the intussusception. This may be the first documentation of spontaneous reduction of the gastroduodenal intussusception during endoscopy.- - - - - - - - - - ranking = 0.13867031257286keywords = duct (Clic here for more details about this article) |
5/284. Enterolith: an unusual cause of afferent loop obstruction.Most cases of enterolith have been reported in association with the diverticula of small bowel. We report here a case of a patient in whom a huge enterolith developed in the afferent loop of Billroth II anastomosis with ensuing obturation obstruction. The enterolith was clearly shown on the preoperative abdominal computed tomograph and was removed through a duodenotomy. The postulated mechanism of the enterolith formation is impaired duodenal evacuatory motor activity due to previous gastrectomy.- - - - - - - - - - ranking = 4.7186368860981keywords = obstruction (Clic here for more details about this article) |
6/284. Retrieval of distally migrated, impacted biliary endoprostheses using a novel guidewire/basket "lasso" technique.BACKGROUND: Migration of biliary endoprostheses is a recognized complication of bile duct stenting. Removing a stent that has migrated is usually straightforward, but this can be challenging when the stent is firmly impacted in the opposite wall of the duodenum or within a diverticulum. We describe a new technique for removing such impacted stents using a guidewire/basket lasso. methods: To perform the lasso technique, a retrieval basket and a guidewire are passed side-by-side through the accessory channel of the duodenoscope. The basket catheter is advanced underneath the stent and the guidewire manipulated over the stent; the basket is opened and the guidewire advanced through it. Closure of the basket creates a loop around the stent that can then be removed using gentle traction. RESULTS: The lasso technique was successfully used in three cases where other maneuvers failed. CONCLUSIONS: Biliary endoscopists should find this technique useful for retrieval of distally migrated biliary stents that are impacted against mucosa or the wall of a diverticulum so as to prevent standard basket extraction.- - - - - - - - - - ranking = 0.93066484371357keywords = bile duct, bile, duct (Clic here for more details about this article) |
7/284. Interventional radiology in percutaneous management of bile duct obstruction: biliary drainage through a spontaneous common hepatic duct-duodenal fistula.Bile duct injuries are a serious complication of biliary surgery. We report a case of benign obstruction of the common hepatic duct associated with common hepatic duct-duodenal spontaneous fistula following complex surgical intervention. We managed percutaneously the fistula with balloon dilatation and long-term stenting, as the fistula allowed biliary flow in the duodenum. We avoided reintervention preserving biliary flow, with good clinical results after a follow-up of a 3 years. We emphasize the role of a clinically focused approach to percutaneous management of complications following biliary surgery.- - - - - - - - - - ranking = 8.9266423549573keywords = obstruction, bile duct, bile, duct (Clic here for more details about this article) |
8/284. gallbladder carcinoma with choledochoduodenal fistula: a case report with surgical treatment.A 79 year-old man was admitted to our hospital because of upper abdominal pain and nausea. A mobile tumor was palpable in the right upper abdomen. Abdominal ultrasonography, computed tomography and celiac angiography revealed a gallbladder tumor. Endoscopic retrograde cholangiopancreatography revealed a fistula 1.5 cm oral to the orifice of the papilla of Vater, dilatation of the common bile duct, and a filling defect in the gallbladder. Pancreatoduodenectomy associated with reconstruction using Imanaga's method was performed under a pre-operative diagnosis of gallbladder carcinoma with choledochoduodenal fistula. The gallbladder contained a tumor and two bilirubin stones impacted in the orifice of the duodenal papilla. Histological studies confirmed that the gallbladder tumor was a mucinous adenocarcinoma and had not infiltrated the bile duct. We speculated that choledochoduodenal fistula stimulated the development of cancer due to chronic irritation from pancreatic juice reflux.- - - - - - - - - - ranking = 1.224557431331keywords = bile duct, bile, duct (Clic here for more details about this article) |
9/284. Perforated duodenal diverticulum: report of two cases.Duodenal diverticula may be complicated by diverticulitis, perforation, hemorrhage, pancreatitis, or biliary obstruction. Two cases of perforated duodenal diverticulum are reported. Both patients were elderly females. Computed tomography of the abdomen showed retroperitoneal air around the duodenum in the first case, and an enterolith in a duodenal diverticulum and a retroperitoneal abscess in the second case. laparotomy and diverticulectomy with two-layer closure of the duodenum was performed in the first case. The second patient was treated conservatively with antibiotics, percutaneous abscess drainage, and endoscopic lithotomy. Both recovered well. Computed tomography is useful in the diagnosis of a perforated duodenal diverticulum. Although surgical intervention is the standard treatment, conservative therapy is also an option. Duodenal enteroliths are rare but may cause perforation of a diverticulum or biliary obstruction. The duodenal blind loop created by a Billroth II gastrectomy provides a static environment for the formation of enteroliths in duodenal diverticula.- - - - - - - - - - ranking = 1.8874547544392keywords = obstruction (Clic here for more details about this article) |
10/284. Duodenal duplication cyst manifested by duodeno-jejunal intussusception and hyperbilirubinemia.A rare case of duodenal duplication cyst containing stones in a 17-year-old patient is presented. The cyst, acting as a leading point for duodeno-jejunal intussusception caused proximal small bowel obstruction and hyperbilirubinemia. Preoperative diagnosis was based on abdominal computerized tomography. At operation, the cyst wall was unroofed creating free drainage into the duodenal lumen without damaging the biliary and pancreatic ducts with resolution of symptoms.- - - - - - - - - - ranking = 1.013062533506keywords = obstruction, duct (Clic here for more details about this article) |
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