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pancreatic diverticulum

G Alessandri, A Amodio, L Landoni, N De' Liguori Carino, C Bassi
OBJECTIVE: Recurrent acute pancreatitis is an uncommon diagnosis in teenagers. Excluded alcohol and biliary stones, more prevalent aetiologies in these group of patients are genetic pancreatitis, pancreatic duct system abnormalities, neoplasia, traumas and congenital abnormalities of the duodenum such as duodenal duplication or diverticulum. Two reported cases of recurrent pancreatitis associated to midgut malrotation were described in English literature. Bowel malrotation is a difficult diagnosis in a teenager or a young adult and a common delay is documented...
November 2016: European Review for Medical and Pharmacological Sciences
R J L F Loffeld, P E P Dekkers
Introduction. Duodenal diverticuli alter the anatomy of the papillary region and can make an ERCP difficult. Aim. To study the outcome of ERCP in cases of duodenal diverticuli. Patients and Methods. Consecutive ERCPs in a period of 24 years were included. Endoscopy reports were studied for presence of diverticuli. Success of the procedure and findings were noted. Clinical records were searched for clinical presentation of the patient. Patients without duodenal diverticuli were used as comparison. Results. 2795 procedures were done in 2092 patients...
2016: International Scholarly Research Notices
Vikram Anand, Justin Provost, Maged Bakr, Christopher Bach, Prakriti Merchant, Christopher Brown, Claudia Gruss
An intraluminal duodenal diverticulum (IDD) is a rare congenital anomaly that is the result of incomplete recanalization of the embryologic foregut leaving a fenestrated membrane within the lumen of the duodenum. Years of peristalsis acting on the membrane result in the formation of a diverticulum. Most patients are asymptomatic, while some may have abdominal pain, bloating, or fullness. Rare complications include gastrointestinal bleeding, obstruction, pancreatitis, and cholangitis. We present 2 cases with endoscopic findings consistent with partially obstructing symptomatic IDD...
August 2016: ACG Case Reports Journal
Gen Tohda, Masahiro Ohtani, Masaki Dochin
AIM: To investigate the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with acute cholangitis. METHODS: From June 2008 to May 2016, emergency ERCPs were performed in 207 cases of acute cholangitis at our institution. Patients were classified as elderly if they were aged 80 years and older (n = 102); controls were under the age of 80 years (n = 105). The patients' medical records were retrospectively reviewed for comorbidities, laboratory data, etiology of cholangitis (presence of biliary stones, biliary stricture and malignancy), details of the ERCP (therapeutic approaches, technical success rates, procedure duration), ERCP-related complications and mortality...
October 7, 2016: World Journal of Gastroenterology: WJG
J Trna, I Penka, B Buliková, V Zbořil, I Novotný
UNLABELLED: Juxtapapillary duodenal diverticula are reported as a potential cause of many pancreatobiliary diseases. However, data concerning this association is inconsistent and the role of the diverticulum is often underestimated or even denied in clinical practice. This case report and literature review is aimed at pointing out this problem.Obstruction of the diverticulum with a food bezoar can be considered as an important clinical clue of the etiological role of the diverticulum in pancreatobiliary disease development...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Chan Sup Shim, Ji Wan Kim, Tae Yoon Lee, Young Koog Cheon
In recent years, endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) has been shown to be an effective technique for the removal of large or difficult common bile duct (CBD) stones, as an alternative to EST. Reviewing the literature published since 2003, it is understood that EPLBD has fewer associated overall complications than EST. Bleeding occurred less frequently with EPLBD than with EST. There was no significant difference in postendoscopic retrograde cholangiopancreatography pancreatitis or perforation...
July 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Samantha Mc Kenzie Stancu, Bogdan Aurelian Popescu, Mircea Beuran
Meckel's Diverticulum is the most common congenital malformation of the gastrointestinal tract with a prevalence of 2 % in the general population, being twice as common and symptomatic in males. Not seldom is the diagnosis made incidentally, upon laparotomy for other intra-abdominal conditions, namely acute appendicitis. Simple Diverticulectomy is the surgical treatment of choice. We present the case of S.M., a 38 year-old male who was admitted to the Surgery Department of the Bucharest Clinical Emergency Hospital for sudden onset of initially periumbilical pain, which later migrated and localized in the right iliac fossa (RIF) accompanied by vomiting after the onset of pain, approximately 24 hours prior to admission...
May 2016: Chirurgia
Pier Alberto Testoni, Alberto Mariani, Lars Aabakken, Marianna Arvanitakis, Erwan Bories, Guido Costamagna, Jacques Devière, Mario Dinis-Ribeiro, Jean-Marc Dumonceau, Marc Giovannini, Tibor Gyokeres, Michael Hafner, Jorma Halttunen, Cesare Hassan, Luis Lopes, Ioannis S Papanikolaou, Tony C Tham, Andrea Tringali, Jeanin van Hooft, Earl J Williams
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations 1 ESGE suggests that difficult biliary cannulation is defined by the presence of one or more of the following: more than 5 contacts with the papilla whilst attempting to cannulate; more than 5 minutes spent attempting to cannulate following visualization of the papilla; more than one unintended pancreatic duct cannulation or opacification (low quality evidence, weak recommendation)...
July 2016: Endoscopy
B Minu Rekha, Anuradha Chandramohan, B Sudhakar Chandran, Visalakshi Jayaseelan, J Suganthy
INTRODUCTION: Duodenal diverticulum (DD) is the second most common diverticulum, yet its incidence varies widely from 1-22% based on the mode of investigation. Computed Tomography (CT) of abdomen is the preferred modality to diagnose acute abdomen including those of complications of DD. Moreover, the prevalence of DD in Indian population is not yet been studied using CT. AIM: The current study aim to look for the prevalence of DD in Indian population using Contrast Enhanced Computed Tomography (CECT) abdomen...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Carin E Reust, Amy Williams
Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception...
May 15, 2016: American Family Physician
Nicolae Bacalbasa, Radu Costin, Carmen Orban, Laura Iliescu, Ioan Hurjui, Marcela Hurjui, Nicoleta Niculescu, Mirela Cristea, Irina Balescu
Meckel diverticulum is the most common abnormality of the gastrointestinal tract arising from an incomplete obliteration of the vitelline duct during the intrauterine life. Although tumor development in Meckel diverticulum is not a common situation, it can occur due to the persistence of cellular islets with gastric, pancreatic or intestinal origin. The presence of a neuroendocrine tumor arising from Meckel diverticulum is even scarcer. We present the case of a 59-year-old patient in whom a Meckel diverticulum was found during surgery for inguinal hernia; the histopathological and immunohistochemical studies revealed the presence of a well-differentiated neuroendocrine tumor with low mitotic index...
April 2016: Anticancer Research
Adero Francis, Diana Kantarovich, Nasim Khoshnam, Adina L Alazraki, Binita Patel, Bahig M Shehata
We report a review of 208 cases of Meckel's diverticulum among pediatric patients from one single institution. One of the aims of this report is to highlight the different diagnostic modalities of Meckel's diverticulum since a majority of cases is undiagnosed prior to surgery. Our review shows 58 cases containing gastric and/or pancreatic heterotopic tissue, including two unique cases. The first case reported is a desmoid tumor arising at the tip of diverticulum, a case that, to our knowledge, has not been previously reported...
2016: Fetal and Pediatric Pathology
Chee Hui Ng, Chau Hung Lee
BACKGROUND: Cystic lesions on the pancreatic head can mimic fluid-filled duodenal or periampullary diverticula. We reviewed a series of cases in which periampullary diverticula were misdiagnosed as cystic pancreatic lesions. CASE REPORT: Case 1. A Chinese woman presented to the surgical outpatient clinic for intermittent upper abdominal discomfort. Contrast-enhanced MRI of the abdomen revealed a cystic-appearing lesion in the region of the pancreatic head, which was reported as a cystic pancreatic lesion...
2016: American Journal of Case Reports
Ahmed Youssef Altonbary, Monir Hussein Bahgat
Periampullary diverticulum (PAD) is duodenal outpunching defined as herniation of the mucosa or submucosa that occurs via a defect in the muscle layer within an area of 2 to 3 cm around the papilla. Although PAD is usually asymptomatic and discovered incidentally during endoscopic retrograde cholangiopancreatography (ERCP), it is associated with different pathological conditions such as common bile duct obstruction, pancreatitis, perforation, bleeding, and rarely carcinoma. ERCP has a low rate of success in patients with PAD, suggesting that this condition may complicate the technical application of the ERCP procedure...
March 25, 2016: World Journal of Gastrointestinal Endoscopy
Jayabal Pandiaraja
Meckel's diverticulum is a true diverticulum from remnant of vitelline duct. It is most common congenital anomaly of intestine. It is associated with intestinal atresia and anorectal anomalies. It contains heterotrophic epithelium. Most common heterotrophic mucosa is gastric followed by pancreatic tissue. Adenocarcinoma arising from Meckel's diverticulum is very rare. Spontaneous perforation of adenocarcinoma rarely reported. Most of perforation reported in Meckel's diverticulum diagnosed during intraoperative period...
November 2015: Journal of Clinical and Diagnostic Research: JCDR
Walid Elmoghazy, Islam Noaman, Ahmed-Emad Mahfouz, Ahmed Elaffandi, Hatem Khalaf
INTRODUCTION: Intramural duodenal hematoma (IDH) is a rare pathological entity that occurs as a complication of trauma, pancreatitis, peptic ulcer disease or endoscopic biopsy procedures. In this report, we present a case of IDH related to a duodenal diverticulum that was complicated by intra-abdominal bleeding and peritonitis. PRESENTATION OF CASE: We report a 31-year old male who presented with pancreatitis that was complicated with IDH, as diagnosed using endoscopy and CT scan of the abdomen...
2015: International Journal of Surgery Case Reports
Tae Young Park, Jong Sik Kang, Tae Jun Song, Sang Soo Lee, Hyuk Lee, Jung Sik Choi, Hong Jun Kim, Ji Woong Jang
BACKGROUND AND AIMS: ERCP is a difficult procedure to perform in Billroth II gastrectomy patients because of altered anatomy. We investigated the outcomes and risk factors for adverse events with ERCP using a cap-fitted forward-viewing endoscope with endoscopic papillary balloon dilation (EPBD) in Billroth II gastrectomy patients. METHODS: The records for Billroth II gastrectomy patients who underwent ERCP using a cap-fitted forward-viewing endoscope with EPBD at 5 institutions between August 2008 and April 2014 were retrospectively reviewed...
June 2016: Gastrointestinal Endoscopy
Li-Wei Lin, Chin-Chu Wu, Lee-Won Chong, Aming Chor-Ming Lin
Endoscopic Retrograde Cholangiopancreatography (ERCP) is widely used for the diagnosis and treatment of biliary and pancreatic tract disease. Perforation is a rare complication of it, but it is associated with high rate of mortality, an overall mortality rate of 1.0-1.5%. Here, a case of massive subcutaneous emphysema following ERCP was reported without an obvious retroperitoneal or peritoneal perforation.
2015: Emergency (Tehran, Iran)
Hussein Hassan Okasha, Hoda Mahmoud Amin, Mostafa Al-Shazli, Ahmed Nabil, Hossam Hussein, Reem Ezzat
Gastrointestinal stromal tumors (GISTs) can occur anywhere along the gastrointestinal tract especially the stomach and upper small bowel. They are usually solid, but cystic degeneration, necrosis, and focal hemorrhage have been described in larger tumors leading to central necrotic cavitation. The most sensitive marker of GIST is CD117 (c-kit). In computed tomography (CT) scan, it is often difficult to decide the origin of the primary tumor, especially in large GISTs. We report an incidental case of a large duodenal GIST fistulizing into the second part of the duodenum with a large amount of fluid and gas inside, mistaken for a cystic pancreatic neoplasm by CT and mistaken for a duodenal diverticulum by endoscopic ultrasound...
July 2015: Endoscopic Ultrasound
Gary Sharp, Daniel Kozman
Cases of inverted intraluminal Meckel's diverticulum (MD) containing a lipoma, pancreatic and gastric ectopic tissue resulting in intussusception are extremely rare. We have been unable to locate any such presentation in a Crohn's patient; here, we discuss one such case. MD is the most common congenital malformation of the human gastrointestinal tract. Its paediatric preponderance may result in its oversight in the adult population as a cause for symptoms. Intestinal obstruction is the most common adult presentation in non-inverted MD, whereas haemorrhage and anaemia are the most frequent presenting complaint with an 'inverted' MD...
2015: Journal of Surgical Case Reports
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