• Title/Summary/Keyword: Duodenal perforation

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

  • Yoon, Jeung-seuk
    • Journal of Trauma and Injury
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    • v.25 no.4
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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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    • v.55 no.1
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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.

Laparoscopic Primary Repair with Omentopexy for Duodenal Ulcer Perforation: A Single Institution Experience of 21 Cases

  • Ma, Chung Hyeun;Kim, Min Gyu
    • Journal of Gastric Cancer
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    • v.12 no.4
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    • pp.237-242
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    • 2012
  • Purpose: Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our study was designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer perforation, and provide a step-by-step protocol with tips and recommendations for less experienced surgeons. Materials and Methods: Between March, 2011 and May, 2012, 21 patients presenting with duodenal ulcer perforation underwent laparoscopic primary repair with omentopexy. There were no contraindications to perform laparoscopic surgery, and the choice of primary repair was decided according to the size of the perforation. The procedure for laparoscopic primary repair with omentopexy consisted of peritoneal lavage, primary suture, and omentopexy using a knot pusher. Results: During the operation, no conversion to open surgery or intra-operative events occurred. The median operation time was 45.0 minutes (20~80 minutes). Median day of commencement of a soft diet was day 6 (4~17 days). After surgery, the median hospital stay was 8.0 days (5~27 days). Postoperative complications occurred in one patient, which included a minor leakage. This complication was resolved by conservative management. Conclusions: Although our study was carried out on a small number of patients at a single institution, we conclude that laparoscopic primary repair can be an effective surgical method in the treatment of duodenal ulcer perforation. We believe that the detailed explanation of our procedure will help beginners to perform laparoscopic primary repair more easily.

An unusual cause of duodenal perforation due to a lollipop stick

  • Kim, Mi Jin;Seo, Jeong Meen;Lee, Yoon;Lee, Yoo Min;Choe, Yon Ho
    • Clinical and Experimental Pediatrics
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    • v.56 no.4
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    • pp.182-185
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    • 2013
  • Children have a natural tendency to explore objects with their mouths; this can result in the swallowing of foreign objects. Most ingested foreign bodies pass uneventfully through the gastrointestinal tract. However, some foreign bodies cause obstruction or perforation of the gastrointestinal tract, requiring surgical intervention. Perforation of the gastrointestinal tract may be associated with considerable morbidity and mortality. The most common sites of intestinal foreign body perforation are the ileocecal and rectosigmoid regions. Foreign body perforation of the duodenum is relatively uncommon. We report the first Korean case of duodenal perforation by an ingested 8-cm lollipop stick. Lollipops are popular with the children and fairly accessible to them, as most parents are not aware of their potential harm. Pediatric clinicians should be aware of the risks associated with lollipop stick ingestion. Our report also describes the feasibility and safety of laparoscopic diagnosis and management of pediatric patients with peritonitis induced by the ingestion of foreign bodies.

Traumatic Perforation of the Duodenal Diverticulum: A Case Report (외상후 발생한 십이지장 게실 천공 1예)

  • Kim, Ho Hyun;Park, Yun Chul;Lee, Dong Kyu;Park, Chan Yong;Kim, Jae Hun;Kim, Yeong Dae;Kim, Jung Chul
    • Journal of Trauma and Injury
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    • v.26 no.2
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    • pp.53-57
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    • 2013
  • A duodenal diverticulum is a frequent abnormality that is usually diagnosed incidentally. Clinical manifestations usually mimic those of highly-varied entities. Among the complications of a duodenal diverticulum, perforation is fairly rare; rupture due to blunt trauma is even rarer, and no cases have been reported in Korean literature. We report the case of a 61-year-old male patient who presented with a perforated duodenal diverticulum after a blunt trauma. We also review the existing literature.

Usefulness of the S-O clip for duodenal endoscopic submucosal dissection: a propensity score-matched study

  • Ippei Tanaka;Dai Hirasawa;Hiroaki Saito;Junichi Akahira;Tomoki Matsuda
    • Clinical Endoscopy
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    • v.56 no.6
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    • pp.769-777
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    • 2023
  • Background/Aims: Endoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal tumors (SNADETs) is associated with a high rate of en bloc resection. However, the technique for ESD remains challenging. Recent studies have demonstrated the effectiveness of S-O clips in colonic and gastric ESD. We evaluated the efficacy and safety of duodenal ESD using an S-O clip for SNADETs. Methods: Consecutive patients who underwent ESD for SNADETs between January 2011 and December 2021 were retrospectively enrolled. Propensity score matching analysis was used to compare patients who underwent duodenal ESD with the S-O clip (S-O group) and those who underwent conventional ESD (control group). Intraoperative perforation rate was the primary outcome, while procedure time and R0 resection rate were the secondary outcomes. Results: After propensity score matching, 16 pairs were created: 43 and 17 in the S-O and control groups, respectively. The intraoperative perforation rate in the S-O group was significantly lower than that in the control group (p=0.033). A significant difference was observed in the procedure time between the S-O and control groups (39±9 vs. 82±30 minutes, respectively; p=0.003). Conclusions: The S-O clip reduced the intraoperative perforation rate and procedure time, which may be useful and effective in duodenal ESD.

Duodenal Complication After Open Heart Surgery Report of Three cases (개심술후 발생한 십이지장궤양 합병증 -3례 보고-)

  • Heo, Jae-Park;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1251-1253
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    • 1997
  • Gastrointestinal complications, especially duodenal complication after cardiopulmonary bypass are rare, but often fatal. We experienced 1 case of duodenal ulcer bleeding and 2 cases of duodenal ulcer perforation developing after cardiopulmonary bypass from August 1994 to April 1996. In the case of duodenal ulcer bleeding, palpitation, dizziness, tachycardia and melena were the clues leading to diagnosis, and in the cases of perforation, abdominal distension with pain, tachycardia, hypotension, oliguria were the clues. Duodenal perforations were diagnosed by abdominal paracentesis. The patient with duodenal bleeding was treated by H-2 receptor antagonist, antacids and transfusion. And emergency laparotomy was required for the patients with duodenal perforation. In addition to ulcer prophylaxis including H-2 receptor antagonist and antacids, a high index of suspicion and timely surgery are necessary for early diagnosis and appropriate treatment of duodenal complication developing af er cardiopulmonary bypass.

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Duodenal Perforation: Unusual Complication of Gastrostomy Tube Replacement

  • Kim, Soo-Hong;Min, Sa-Hong;Kim, Hyun-Young;Jung, Sung-Eun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.2
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    • pp.112-115
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    • 2014
  • Feeding gastrostomy is widely used for children with feeding impairment. The replacement of gastrostomy tube is known as an easy and safe procedure. However, various complications associated with replacement of gastrostomy tube were reported, including fistula disruption and colo-cutaneous fistula. For replacement of gastrostomy tube in small children with small stomach, special cautions are needed. Here, we report a rare case of duodenal perforation as an acute complication after the replacement of gastrostomy tube for a 33-month-old girl.

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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    • v.33 no.1
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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.

A Clinical Study of Congenital Intestinal Atresia and Stenosis (선천성 장폐쇄 및 협착에 대한 임상적 고찰)

  • Kim, Sang-Woo;Jung, Poong-Man
    • Advances in pediatric surgery
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    • v.3 no.2
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    • pp.117-125
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    • 1997
  • Seventy neonates with congenital intestinal atresia and stenosis who were treated at pediatric surgical service. Hanyang University Hospital from September 1979 to December 1996 were analyzed retrospectively. The lesion occurred in 27 cases at the duodenum, in 26 cases at the jeiunum, in 13 cases at the ileum and in 2 cases at the pylorus and colon each. There were 10 multiple atresias and 7 apple-peel anomaly cases. The atresia predominated over the stenosis by the ratio of 4 : 1. Male to female ratio was 1.3 : 1. The average gestational age was 38 weeks, and the average birth weight was 2,754 grams. Though 22.9 % were borne prematurely and 34.3 % had low birth weight, 92.3 % of them had a weight appropriate for gestational age. Polyhydramnios(40 %) was more frequently observed in duodenal and jeiunal atresia while microcolon in ileal atresia(58.3 %). Weight loss and electrolyte imbalance occurred more frequently in the duodenal stenosis cases because of delayed diagnosis. Twenty(55.6 %) of 37 jeiunoileal atresia cases had evidence of intrauterine vascular accident : 4 intrauterine intussusception, 3 intrauterine volvulus and 3 strangulated intestine in gastroschisis, and 10 cases of intrauterine peritonitis. There were one or more associated anomalies in 45 patients (64.3 %). Preoperatively proximal loop volvulus developed in 3 cases and proximal loop perforation in 5 cases and one case each of distal loop perforation, duodenal perforation and midgut volvulus occurred in the jeiunoileal atresia. Overall mortality rate was 20 %.

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