• Title/Summary/Keyword: Duodenal perforation

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Covered Self-expandable Metallic Stent Insertion as a Rescue Procedure for Postoperative Leakage after Primary Repair of Perforated Duodenal Ulcer (십이지장 궤양 천공 단순 봉합수술 후 완전 피막형 자가확장 금속 스텐트 삽입술로 치료된 봉합 부위 누출)

  • Yoo, Young Jin;Lee, Yong Kang;Lee, Joong Ho;Lee, Hyung Soon
    • The Korean Journal of Gastroenterology
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    • v.72 no.5
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    • pp.262-266
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    • 2018
  • Surgery has been the standard treatment for perforated duodenal ulcers, with mostly good results. However, the resolution of postoperative leakage after primary repair of perforated duodenal ulcer remains challenging. There are several choices for re-operation required in persistent leakage from perforated duodenal ulcers. However, many of these choices are complicated surgical procedures requiring prolonged general anesthesia that may increase the chances of morbidity and mortality. Several recent reports have demonstrated postoperative leakage after primary repair of a perforated duodenal ulcer treated with endoscopic insertion using a covered self-expandable metallic stent, with good clinical results. We report a case with postoperative leakage after primary repair of a perforated duodenal ulcer treated using a covered self-expandable metallic stent.

A Case of Recurrent Liver Abscess Due to Choledochoduodenal Fistula (재발하는 간농양에서 총담관-십이지장 누공의 내시경적 치료 1예)

  • Hur, Jun Ho;Choi, Sun Taek;Sohn, Min Su;Lee, Ji Eun;Chung, In Hee;Ki, Sung Ho
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.39-42
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    • 2013
  • Cholelithiasis, duodenal ulcer, duodenal perforation and tumor invasion may lead to choledochoduodenal fistula (CDF). CDF often has no specific symptoms and may be incidentally detected in an upper gastrointestinal radiographic study or endoscopy; but in some cases, it may be accompanied by recurrent cholangitis and liver abscess. In this paper, a case of recurrent liver abscess caused by CDF is reported. A 62-year-old female was admitted to the authors' hospital because of right upper quadrant pain and fever. The abdominal computed tomography showed a liver abscess in the right lobe. A duodenal fistulous orifice was detected with endoscopy, and a contrast was injected through the duodenal orifice using a catheter under fluoroscopy. The injection of the contrast revealed a fistulous track between the duodenal bulb and the common hepatic duct. In fistulas complicated by recurrent liver abscess, surgery or medical management may be needed. The CDF in this case study was treated via endoscopic clipping.

Duodenal Obstruction due to Peptic Ulcer in Children (소아에서 소화성 궤양으로 인한 십이지장 폐색증)

  • Huh, Young-Soo;Lee, Won-Jong;Kim, Wook-Dong;Suh, Bo-Yang;Kwun, Kwoing-Bo
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.43-46
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    • 1989
  • Primary peptic ulcer disease is not known to be the result of underlying illness or traum. These are most frequently duodenal or prepyloric. Since clinical features of peptic ulcer in children can easily be confused with many other disorders, the diagnosis is usually made when one of the more dramatic presentations, such as perforation, bleeding and obstruction. Recently, we experienced 2 cases of duodenal obstruction due to peptic ulcer in children. So, we report it with review of references.

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A Case of Midgut Volvulus with Gastric Perforation and Periveintricular Leukomalacia in a Term Infant

  • Park, Seul Gi;Hwang, Jong Hee
    • Neonatal Medicine
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    • v.28 no.1
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    • pp.53-58
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    • 2021
  • Intestinal malrotation with midgut volvulus (MV) is a life-threatening surgical emergency. Most events of MV occur in the neonatal period with bilious vomiting, abdominal distension, feeding intolerance, and bloody stools. Neonatal gastric perforation (GP) is a rare and life-threatening condition associated with high mortality. It occurs either in an idiopathic form or in association with gastrointestinal anomalies such as duodenal atresia and MV. The pathogenesis of both MV and GP is related to ischemic change and inflammatory response. MV and GP can lead to morbidities such as sepsis, intestinal ischemia, and organ failure, but not neurologic problems. We herein report the case of a term infant at 5 days after birth, with MV accompanied by GP, who developed periventricular leukomalacia.

Gizzard impaction and duodenal perforation in a yellow-billed spoonbill (Platalea leucorodia)

  • Ho-Seong, Cho;Yeonsu, Oh
    • Korean Journal of Veterinary Service
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    • v.45 no.4
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    • pp.331-335
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    • 2022
  • A yellow-billed spoonbill kept at the zoo was found dead. As a result of the necropsy, the stomach (gizzard and proventriculus) and duodenum were full of undigested fish bones, and the undigested sharp fish bones were lodged in the gastric mucosa and clumped together, blocking the lumen. Thereafter, the intestinal wall was perforated and peritonitis occurred causing death. The cause of the fish spines becoming lodged in the gastrointestinal tract is unknown. It can only be assumed that there was a lack of a mechanism for the yellow-billed spoonbill in a zoo to go around and pick up grit or small stones and assist in mechanical crushing in the gizzard.

A Case of Duodenal Brunner's Gland Adenoma Treated by Endoscopic Rescetion (내시경으로 절제한 십이지장 Brunner선 선종 1예)

  • Kim, Sung-Joon;Gu, Min-Geun;Park, Jun-Suk;Kim, Kyeong-Ok;Lee, Si-Hyung;Kim, Tae-Nyeun;Choi, Jun-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.28 no.1
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    • pp.84-89
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    • 2011
  • Brunneroma, also known as Brunner's gland adenoma or harmatoma, is a very rare benign tumor of the duodenum, which is usually asymptomatic, and is discovered incidentally during endoscopic exam. These lesions are most commonly located in the duodenal bulb and clinical manifestations are variable. We report on a case of a large Brunner's gland adenoma in a 54-year-old man, which was successfully removed by endoscopic resection without complications, such as bleeding or perforation. Microscopically, it was composed entirely of variable Brunner's gland.

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A Clinical Analysis of Complicated Gastroduodenal Ulcer in Children (소아에서의 합병성 위십이지장 궤양)

  • Jung, Kwang-Yong;Jeong, Yeon-Jun;Kim, Chan-Young;Yang, Doo-Hyun;Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.10 no.1
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    • pp.22-30
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    • 2004
  • A total of 30 cases of the peptic ulcer in children, who underwent operations from January 1981 to December 1995 because of complications at Department of the Surgery, Chonbuk National University Medical School, is reviewed. Twenty-three were males (76.7%), 7 females (23.3%) and male was preponderant at 3.3:1. There were 25 cases (83.3%) age 10 to 15 years, 3(10.0%) between 2 and 9 years, and 2 (6.7%) below 2. The ulcer was located at duodenum in 27(90.0%), and at stomach in 3 cases (10.0%). Complications were perforation in 19 cases (63.3%), pyloric obstruction in 9 (30.0%) and bleeding in 2 (6.7%). For perforation, truncal vagotomy with pyloroplasty was done in 11 cases, truncal vagotomy with hemigastrectomy and gastrojejunostomy in 6, and simple closure in 2 cases. For obstruction, truncal vagotomy with hemigastrectomy and gastrojejunostomy was done in 5, and truncal vagotomy and pyloroplasty in 3 cases. For bleeding lesions, truncal vagotomy and pyloroplasty was performed in 2 cases. Ten postoperative complications developed in 9 patients: adhesive ileus in 5, recurrence in 2, pneumonia 2, and wound seroma 1 case. One patient developed a primary duodenal perforation and another a recurrent obstruction. Both of patients had symptoms for more than 3 years and were treated with truncal vagotomy and pyloroplasty for the primary operations. Hospital stay was 11.5 days for the patient with perforated ulcer, 11.0 days for the patient with pyloric obstruction, and 14.5 days for the child with bleeding. Average hospital period was 11.6 days. To reduce recurrences after operation, extensive procedure such as distal gastrectomy with vagotomy at the first operation should be considered in case with severe complication or with patients who have been symptomatic for long periods.

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Transcholecystic Duodenal Drainage as an Alternative Decompression Method for Afferent Loop Syndrome: Two Case Reports (들장관증후군의 대체 감압 치료로서 경담낭 십이지장 배액술: 두 건의 증례 보고)

  • Jihoon Hong;Gab Chul Kim;Jung Guen Cha;Jongmin Park;Byunggeon Park;Seo Young Park;Sang Un Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.661-667
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    • 2024
  • Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

A Case of Gastroduodenal Fistula Caused by Ingested Magnetic Foreign Bodies (자석 이물에 의한 위-십이지장 누공 1예)

  • Lee, Won-Hee;Min, Young-Don;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.84-88
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    • 2008
  • If multiple magnets are ingested, the potential exists for the magnets attracting one another across the gastrointestinal tract and inducing pressure necrosis, perforation, fistula formation, or intestinal obstruction. We report the case of a 12-year-old boy who suffered from a fistulous communication between the lesser curvature of the mid-body of the stomach and the duodenal bulb, caused by 4 ingested magnets (Singing Magnets, China). The patient presented with moderate mental retardation, a one-year history of cyclic vomiting, and abdominal discomfort. We present the findings of simple abdominal radiography, esophagogastroduodenoscopy, computed tomography, and upper gastrointestinal series. An emergency exploratory laparotomy was performed, which revealed a gastroduodenal fistula. Fistula repair and the removal of 4 magnetic toys were subsequently performed. We emphasize that clinicians who care for children should be aware of the hazards of magnetic toy ingestion.

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Ultrasonographic Diagnosis of Pneumoperitoneum Associated with a Mast Cell Tumor in a Dog (개에서 비만세포종과 관련된 기복증의 초음파학적 진단례)

  • Wang, Ji-Hwan;Park, Ki-Tae;Lee, Kyung-Woo;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.483-487
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    • 2010
  • A 7-year-old female maltese dog with anorexia and vomiting for a week, and left axillary and perineal mass was admitted to Gyeongsang National University Veterinary Teaching Hospital. CBC revealed mild leukocytosis and severe anemia. Abdominal radiography revealed multiple gas opacities in upper abdomen. On ultrasonography, large amount of echogenic free abdominal fluid were detected. In addition, There are enhanced peritoneal strip sign (EPSS) indicating peumoperitoneum in the upper abdomen. Fine needle aspiration of the mass was performed and the result was mast cell tumor. Duodenal perforation caused by mast cell tumor was identified on laparotomy.