1/954. Pouching a draining duodenal cutaneous fistula: a case study. Blockage of the mesenteric artery typically causes necrosis to the colon, requiring extensive surgical resection. In severe cases, the necrosis requires removal of the entire colon, creating numerous problems for the WOC nurse when pouching the opening created for effluent. This article describes the management of a draining duodenal fistula in a middle-aged woman, who survived surgery for a blocked mesenteric artery that necessitated the removal of the majority of the small and large intestine. Nutrition, skin management, and pouch options are described over a number of months as the fistula evolved and a stoma was created. ( info) |
| A case of tuberculous stricture of the third part of the duodenum was detected by duodenoscopy. Endoscopic biopsy, however, failed to reveal the histological diagnosis. The possible role of endoscopic follow-up of tubercular strictures is indicated. ( info) |
3/954. Successful repair of an idiopathic spontaneous aortoduodenal fistula. A case of idiopathic spontaneous aortoduodenal fistula treated surgically is reported. This case is probably the first successful repair of an idiopathic fistula to be recorded in the literature. The difficulty in diagnosis and possible aetiology are discussed. ( info) |
4/954. 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. ( info) |
| 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. ( info) |
6/954. 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. ( info) |
7/954. Laparoscopic resection for ectopic gastric mucosa of the duodenum: report of a case. We report herein the case of a 53-year-old man in whom ectopic gastric mucosa was successfully resected laparoscopically. radiography and endoscopy showed a well-demarcated and sessile polypoid lesion measuring 2.0 cm in diameter in the second part of the duodenum. Under the diagnosis of a submucosal tumor of the duodenum, a wedge resection of the duodenum was performed laparoscopically. Subsequent histological examination revealed that the tumor was ectopic gastric mucosa of the duodenum. ( info) |
8/954. Primary T-cell lymphoma of the duodenum: report of a case. A case of primary non-Hodgkin's T-cell lymphoma of the duodenum is presented. A 41-year-old man was hospitalized in 1984 complaining of abdominal distention and vomiting. Hypotonic duodenography showed an encircling filling defect in the second portion of the duodenum, and a biopsy specimen revealed features of malignancy suggestive of either undifferentiated carcinoma or malignant lymphoma. Radical surgery (pancreaticoduodenectomy) was performed, after which chemotherapy was administered. A histological evaluation of the duodenal tumor showed it to be non-Hodgkin's lymphoma. It was a diffuse, large-cell type, which immunohistochemically suggested it to be of T-cell origin. Currently the patient is doing well, with no evidence of disease recurrence 13 years after surgery. ( info) |
9/954. Primary aortoduodenal fistula. The aortoenteric fistula is a well-known but uncommon cause of gastrointestinal haemorrhage. It is usually secondary to previous reconstructive surgery of an abdominal aortic aneurysm. Primary aortoenteric fistula is a rare disorder which predominantly occurs in the duodenum. We report the case of a 76-year-old patient who presented with melaena and hypovolaemic shock due to a primary aortoduodenal fistula. Pathogenesis, diagnostic procedures and postmortem pathologic examination of this condition are discussed. The value of computed tomography in establishing the diagnosis is emphasized. ( info) |
10/954. Systemic amyloidosis and sacroiliitis in a patient with systemic lupus erythematosus. We report a case of a 25-year-old female with juvenile onset systemic lupus erythematosus who developed systemic secondary amyloidosis with renal and gastrointestinal involvement. She has also had radiological signs of bilateral asymptomatic sacroiliitis without lower back pain or hla-b27 antigen. ( info) |