1/63. Percutaneous endoscopic duodenostomy: the relief of obstruction in advanced gastric carcinoma.nausea and vomiting in patients with advanced gastric malignancy and mechanical obstruction are distressing and difficult to manage. We describe a patient with linitis plastica and gastric stasis who was treated with a percutaneous endoscopic duodenostomy as the stomach could not be used for percutaneous endoscopic gastrostomy (PEG) formation. A Conflo PEG tube was inserted into the second part of the duodenum using the Ponsky-Gauderer technique without complication. The patient experienced excellent symptomatic relief and tolerated enteral nutrition extremely well, regaining some weight. This manoeuvre can produce effective symptom palliation allowing the patient to be managed at home during the terminal phase of their illness.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
2/63. Primary hypertrophic tuberculosis of the pyloroduodenal area: report of 2 cases.tuberculosis of the stomach and duodenum is rare in patients with pulmonary tuberculosis. Primary involvement is even rarer. Two cases of primary tuberculosis of the localised to the pyloro-duodenal area are presented. The most common symptoms are non-specific leading to a difficulty in establishing a pre-operative diagnosis. A high degree of suspicion is therefore required for its diagnosis and to differentiate it from more frequent causes of gastric outlet obstruction such as chronic peptic ulcer disease and gastric carcinoma. The treatment of gastric tuberculosis is primarily medical with anti-tuberculous drug therapy. The role of surgery lies in the cases with obstruction following hypertrophic tuberculosis. The surgery done is usually a gastroenterostomy. With the relative rate of extra-pulmonary tuberculosis increasing, tuberculosis of the pyloro-duodenal area should be considered in the differential diagnosis of gastric outlet obstruction.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
3/63. Upper gastrointestinal hemorrhage secondary to erosion of a biliary Wallstent in a woman with pancreatic cancer.A 77-year-old patient with unresectable pancreatic adenocarcinoma sustained a life-threatening, upper gastrointestinal hemorrhage 1 month after placement of a biliary Wallstent. Radiographic and endoscopic studies revealed a choledocho-arterio-enteric fistula caused by erosion of the stent through the posterior duodenal wall. The patient was treated successfully with arterial embolization. This represents an unusual case of arterial bleeding with choledocho-arterio-enteric fistulization into the duodenum subsequent to biliary stent erosion.- - - - - - - - - - ranking = 0.085469458018831keywords = cancer (Clic here for more details about this article) |
4/63. Treatment of a malignant stenosis of the corpus of the stomach with a self-expanding stent.In a 50-year-old man, a self-expandable stent was implanted under fluoroscopic guidance to treat symptoms of an inoperable carcinoma of the corpus of the stomach. Foreshortening of the stent necessitated implantation of a proximal extension stent 5 weeks later. Secondary symptoms of advanced stage of the disease negatively influenced clinical success of the procedure, although free passage through the stents was achieved. We conclude that stent implantation for palliation of a carcinoma of the corpus of the stomach seems to be a viable method. The operator has to be aware of the special limitations and problems associated with the procedure.- - - - - - - - - - ranking = 6keywords = stomach (Clic here for more details about this article) |
5/63. Eosinophilic gastritis--an unusual cause of gastric outlet obstruction.Eosinophilic gastroenteritis is a rare entity. We report a 41-year-old man who presented with features of gastric outlet obstruction due to a submucosal lesion in the distal end of the stomach. Distal gastrectomy with Billroth II reconstruction was done. histology showed eosinophilic gastritis infiltrating the muscular and serosal layers of the pylorus and antrum.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
6/63. Abdominal cancer, nausea, and vomiting.nausea and vomiting in abdominal cancer is perhaps one of the most difficult symptom complexes to manage, especially when complicated by bowel obstruction. There are many mechanisms of nausea in advanced abdominal cancer with a number of therapeutic interventions that can significantly enhance symptom control and overall quality of life. As with pain, the ideal approach should include a mechanistic analysis of the causes of nausea beginning with a thorough history, followed by a directed physical examination, and selected laboratory studies. The symptom history, in conjunction with a physical examination and directed tests should direct appropriate pharmacologic and nonpharmacologic interventions. The result is often the amelioration of significant suffering and enhanced quality of living.- - - - - - - - - - ranking = 0.12820418702825keywords = cancer (Clic here for more details about this article) |
7/63. Intragastric gallstone-induced bezoar: an unusual cause of acute gastric outlet obstruction.bezoars are an uncommon cause of acute gastric outlet obstruction. To our knowledge, this is the first report of a bezoar formed around a gallstone that migrated to the stomach via a cholecystogastric fistula. Our patient was a 42-year-old African American woman with long-standing type 2 diabetes. We suspect that diabetic diathesis was the major factor responsible for producing the pathologic derangement of the gallbladder and stomach, which led to development of the bezoar and serious complications.- - - - - - - - - - ranking = 2keywords = stomach (Clic here for more details about this article) |
8/63. Gastroduodenal intussusception due to peutz-jeghers syndrome in infancy.A case of peutz-jeghers syndrome (PJS) presenting in infancy with gastric-outlet obstruction is described. PJS may become symptomatic at any age and should be suspected when there are obstructive symptoms or gastrointestinal blood loss in a baby with a positive family history. Contrast studies and endoscopy are useful in diagnosis and surveillance. Treatment requires a combination of endoscopy and laparotomy/laparoscopy. Because of the reported cancer risk, we recommend surveillance from the age of diagnosis.- - - - - - - - - - ranking = 0.021367364504708keywords = cancer (Clic here for more details about this article) |
9/63. Heterotopic pancreatitis: gastric outlet obstruction due to an intramural pseudocyst and hamartoma.Heterotopic pancreas, usually a silent gastrointestinal malformation, may become clinically evident when complicated by chronic inflammation. We report a case of pancreatitis and extensive pseudocyst formation in the gastric antrum, which caused gastric outlet obstruction. The diagnosis was obscured by a history of emesis during pregnancy and a previously resected gastric polyp. The nature of the obstructive lesion was not diagnosed preoperatively in spite of endosonographic evaluation. Intraoperatively, a cystic tumor of the stomach wall was found, the lesion was excised, and a pyloroplasty was performed to close the excision site. histology revealed heterotopic pancreatic tissue with chronic inflammation, fibrosis and pseudocyst formation and adjacent to this lesion a myoglandular hamartoma. The patient is symptom-free two years after surgery and no recurrence was found. The nature of heterotopic pancreatic tissue, its diagnosis and management are discussed.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
10/63. Co-existence of a huge pseudocyst and mucinous cystadenoma: report of a case and the value of magnetic resonance imaging for differential diagnosis.Co-existence of a pancreatic pseudocyst and a neoplastic cyst is rare and their differential diagnosis is difficult if the patient has an atypical history as well as subclinical symptoms. The formation of a pseudocyst under such circumstances is usually the result of downstream ductal obstruction by the neoplasm. Two large cysts were found in a 43-year-old woman who had symptoms of gastric outlet obstruction that were the result of external compression by one of the cysts. magnetic resonance imaging was superior to computed tomography, discriminating between the internal contents and surrounding tissue of the two cysts, enabling the correct preoperative diagnosis of a pseudocyst co-existing with a mucinous cystadenoma to be made. It was most unusual for the pseudocyst to be located downstream of the mucinous tumour, ruling out ductal obstruction by the tumour in its pathogenesis. A possible explanation for the pseudocyst formation in this case was pancreatic juice accumulation in the space of the lesser sac after pancreatic parenchymal destruction by the mucinous tumour.- - - - - - - - - - ranking = 0.0017026692524783keywords = neoplasm (Clic here for more details about this article) |
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