• 제목/요약/키워드: duodenal

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둔상에 의한 십이지장 손상 - 2예 증례 보고 (Duodenal Injury after Blunt Abdominal Trauma - Report of Two Cases)

  • 김기훈
    • Journal of Trauma and Injury
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    • 제25권3호
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    • pp.94-96
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    • 2012
  • Duodenal injuries following a blunt or penetrating trauma are uncommon and account for just 3% to 5% of all abdominal injuries. About 22% of all duodenal injuries are caused by blunt trauma. An overlooked injury or delayed diagnosis of duodenal injury may lead to increased mortality and morbidity. We report two cases of a duodenal injury following blunt abdominal trauma.

Iatrogenic Duodenal Obstruction due to Acupuncture Therapy Trauma

  • Chung, Jae Hun;Lee, Si-Hak
    • Journal of Trauma and Injury
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    • 제34권1호
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    • pp.70-74
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    • 2021
  • There are many possible causes of duodenal obstruction, such as congenital anomalies and various acquired conditions associated with space-occupying lesions. However, hemorrhage or retroperitoneal hematoma is a rare cause of duodenal obstruction. Here, we report the case of a 55-year-old man who developed duodenal obstruction due to a large retroperitoneal hematoma after acupuncture therapy. The patient experienced abdominal discomfort along with vomiting and nausea. Considering the size of the hematoma, emergency surgery could have been performed, but conservative treatment was continued because the patient's vital signs were stable. With spontaneous resolution of the hematoma, the symptoms of duodenal obstruction improved. The patient was eventually discharged without any complications associated with the hematoma. Our findings suggest that even when a hematoma is large, a conservative approach can be maintained until improvement of the symptoms of duodenal obstruction if the vital signs of the patient remain stable.

Delayed Manifestation of Isolated Intramural Hematoma of the Duodenum Resulting from Blunt Abdominal Trauma

  • Ha, Tae Sun;Chung, Jun Chul
    • Journal of Trauma and Injury
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    • 제33권1호
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    • pp.53-58
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    • 2020
  • Duodenal injury following blunt abdominal trauma is a relatively unusual complication, and it may sometimes be difficult to distinguish a duodenal hematoma from duodenal perforation. According to recent reports, intramural hematomas typically resolve spontaneously with conservative treatment. Surgery, however, is occasionally necessary in some cases if the diagnosis is delayed, conservative therapy fails, or a high degree of suspicion of duodenal injury persists. We experienced a case of delayed manifestation of a duodenal intramural hematoma that was surgically treated.

외상 후 발생한 십이지장 천공 보존적 치료 사례 1례 (Conservative Management of a Duodenal Perforation after Trauma)

  • 윤정석
    • Journal of Trauma and Injury
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    • 제25권4호
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    • pp.271-274
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    • 2012
  • Duodenal perforation has a high incidence of complications and mortality if not detected and treated early. Delayed diagnosis of duodenal perforation is frequent because patients rarely complain of any symptoms. We report a case of duodenal perforation that appeared after trauma and was cured by using conservative treatment.

Endoscopic Suturing for the Prevention and Treatment of Complications Associated with Endoscopic Mucosal Resection of Large Duodenal Adenomas

  • Jaeil Chung;Kelly Wang;Alexander Podboy;Srinivas Gaddam;Simon K. Lo
    • Clinical Endoscopy
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    • 제55권1호
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    • pp.95-100
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    • 2022
  • Background/Aims: Endoscopic mucosal resection (EMR) is the primary treatment for duodenal adenomas; however, it is associated with a high risk of perforation and bleeding, especially with larger lesions. The goal of this study was to demonstrate the feasibility and safety of endoscopic suturing (ES) for the closure of mucosal defects after duodenal EMR. Methods: Consecutive adult patients who underwent ES of large mucosal defects after EMR of large (>2 cm) duodenal adenomas were retrospectively enrolled. The OverStitch ES system was employed for closing mucosal defects after EMR. Clinical outcomes and complications, including delayed bleeding and perforation, were documented. Results: During the study period, ES of mucosal defects was performed in seven patients in eight sessions (six for prophylaxis and two for the treatment of perforation). All ES sessions were technically successful. No early or delayed post-EMR bleeding was recorded. In addition, no clinically obvious duodenal stricture or recurrence was encountered on endoscopic follow-up evaluation, and no patients required subsequent surgical intervention. Conclusions: ES for the prevention and treatment of duodenal perforation after EMR is technically feasible, safe, and effective. ES should be considered an option for preventing or treating perforations associated with EMR of large duodenal adenomas.

Rat Duodenal Mucosa Inositol Monophosphatase; Novel Enzyme of Which Properties are Distinct from Brain Enzyme

  • Kwon, Hyeok-Yil;Lim, Bong-Hee;Park, Hyung-Seo;Lee, Yun-Lyul;Lee, Eun-Hee;Choi, Soo-Young;Park, Hyoung-Jin
    • BMB Reports
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    • 제31권3호
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    • pp.274-280
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    • 1998
  • An inositol monophosphatase (IMPase) was purified to homogeneity from rat duodenal mucosa for the first time and its enzymatic properties were investigated. Rat duodenal mucosa peculiarly exhibited the highest IMPase activity among various rat tissues examined. By means of ammonium sulfate precipitation, followed by Q-Sepharose, polylysine agarose, reactive-red agarose column chromatography, Uno-Q FPLC, and Bio-Silect FPLC, duodenal IMPase was purified 223-fold to a specific activity of 13.6 U/mg protein. The molecular mass of the native enzyme was estimated to be 48,000 Da on gel filtration. The subunit molecular mass was determined by SDS-PAGE to be 24,000 Da. These results indicate that duodenal IMPase is a dime ric protein made up of identical subunits. Rat duodenal IMPase has distinct properties from brain IMPase. It has a broad spectrum of substrate specificity and is insensitive to $Li^+$. Duodenal IMPase does not absolutely require $Mg^{2+}$ for its catalytic activity. Furthermore, duodenal IMPase is less stable to heat than brain enzyme. It is suggested that the rat duodenal mucosa needs a large amount of IMPase whose properties are quite different from that of the brain enzyme.

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십이지장 궤양의 임상적 고찰 (Clinical Study of Duodenal Ulcer)

  • 임남성;문수형;이재황;김강석
    • 보험의학회지
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    • 제9권
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    • pp.130-137
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    • 1990
  • We'd performed the upper gastrointestinal study for a total of 10,047 insureds-male 5,919 female 4,128 persons-who were examined at medical department of Dae Han Kyoyuk Insurance Co., from August, 1986 to December, 1989. The results on duodenal ulcer were as follows; 1) Duodenal ulcer was found in 138 cases(1.37%) among the 10,047 insureds. 2) In all 138 cases who have duodenal ulcer, duodenal ulcer was found in 112 cases(1.89%) among the 5,919 insureds of male and in 26 cases(0.63%) among the 4,128 insureds of female. The incidence of duodenal ulcer in male was higher than in female. 3) The possessing rate of duodenal ulcer is 1.28% in 20 yrs, 1.24% in 30 yrs, 1.72% in 40 yrs, 1.21% in 50 yrs, 0.48% in 60 yrs. 4) The possessing rate of duodenal ulcer in male is 2.24% in 20 yrs, 1.78% in 30 yrs, 1.99% in 40 yrs, 2.05% in 50 yrs, 0.91% in 60 yrs and in female, 0.52% in 20 yrs, 0.48% in 30 yrs, 1.20% in 40 yrs, 0.2% in 50 yrs. 5) Coexistent lesion with duodenal ulcer were found in 19 cases; one case of esophageal diverticulum, one case of gastric diverticulum, one case of duodenal diverticulum, tow cases of gastric ulcer, six cases of gastritis, five cases of duodenitis, two cases of gastroduodenitis, one case of pseudodiverticulum.

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Pancreas-preserving limited duodenal resection: Minimizing morbidity without compromising oncological adequacy

  • Ajay Sharma;Anand Nagar;Peeyush Varshney;Maunil Tomar;Shashwat Sarin;Rajendra Prasad Choubey;V. K. Kapoor
    • 한국간담췌외과학회지
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    • 제26권2호
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    • pp.149-158
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    • 2022
  • Backgrounds/Aims: Pancreaticoduodenectomy is the most common procedure for the management of duodenal pathologies. However, it is associated with substantial morbidity and a low risk of mortality. Pancreas-preserving limited duodenal resection (PPLDR) can be performed under specific scenarios. We share our experience with PPLDR and its outcome. Methods: We retrospectively analyzed a prospectively maintained database of patients undergoing limited duodenal resection in the form of wedge (sleeve) resection or segmental resection of one or more duodenal segments from March 2016 to March 2021 at a tertiary care center in North India. Results: During the study period, 10 patients (including 9 males) underwent PPLDR. Five of these 10 patients showed primary duodenal or proximal jejunal pathology, while the remaining five had duodenal pathology involving an adjacent organ tumor. Four patients underwent wedge (sleeve) resection, while the remaining six underwent segmental duodenal resection of one or more duodenal segments. Mean hospital stay was 6 days (range, 3-11 days) without 30-day mortality. Morbidity occurred in 4 patients (Grade I-II, n = 3; Grade III, n = 1). All patients were alive and disease-free at the time of last follow-up. The mean follow-up duration was 23 months (range, 2-48 months). Conclusions: PPLDR is a safe and effective alternative for pancreaticoduodenectomy when selected carefully for specific tumor types and location.

십이지장 궤양으로 발현된 전이성 간세포암종 1예 (A Case of Hepatoma with Duodenal Metastasis Proved by Liver Aspiration Cytology and Gastrofiberscopic Duodenal Biopsy)

  • 김성진;박석건;한동선;김성숙
    • 대한세포병리학회지
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    • 제2권2호
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    • pp.105-110
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    • 1991
  • We report a case of hepatoma with duodenal metastasis in a 53 year-old male patient. Hepatoma was confirmed by fine needle aspiration cytology technique, and duodenal metastasis by gastrofiberscopic biopsy. Duodenal metastasis of hepatoma is rare. We briefly review the role of fine needle aspiration cytology technique in diagnosis of hepatoma.

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Current Treatment Strategy for Superficial Nonampullary Duodenal Epithelial Tumors

  • Tetsuya Suwa;Kohei Takizawa;Noboru Kawata;Masao Yoshida;Yohei Yabuuchi;Yoichi Yamamoto;Hiroyuki Ono
    • Clinical Endoscopy
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    • 제55권1호
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    • pp.15-21
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    • 2022
  • Endoscopic submucosal dissection (ESD) is the standard treatment method for esophageal, gastric, and colorectal cancers. However, it has not been standardized for duodenal lesions because of its high complication rates. Recently, minimally invasive and simple methods such as cold snare polypectomy and underwater endoscopic mucosal resection have been utilized more for superficial nonampullary duodenal epithelial tumors (SNADETs). Although the rate of complications associated with duodenal ESD has been gradually decreasing because of technical advancements, performing ESD for all SNADETs is unnecessary. As such, the appropriate treatment plan for SNADETs should be chosen according to the lesion type, patient condition, and endoscopist's skill.