Presentation
In this challenging presentation, the presence of the coin led to the correct diagnosis. Patients with congenital duodenal anomalies may present a number of associated abnormalities. [ncbi.nlm.nih.gov]
We present a case of an inverted duodenal diverticulum in a patient that presented with an upper intestinal obstruction. [academic.oup.com]
Entire Body System
- Fever
We report a 45-year-old woman, with a five days history of high fever along with epigastric and periumbilical pain. Physical examination revealed right upper and lower quadrant tenderness with peritoneal signs. [ncbi.nlm.nih.gov]
Abstract An 84-year-old woman was brought to our emergency outpatient clinic with fever, epigastralgia, and back pain. On blood analysis, mild anemia and leukocytosis were noted. [jstage.jst.go.jp]
- Falling
Keeping in view continued malena and fall in Hb, upper gastrointestinal (UGI) barium series with small bowel follow through was done. [japi.org]
胃肝間膜 gastro-hepatic ligament 胃結腸間膜 gastro-colic ligament 胃脾間膜 gastro-lienal ligament (gastro-splenic ligament) 胃の形態 form of the stomach 砂時計胃 hourglass stomach, bilocular deformity 嚢状胃 wallet stomach 瀑状胃 cascade stomach, cup and spill deformity, water fall [jsge.or.jp]
There is no communication with the duodenal lumen (*) Fig. 2 Ruptured duodenal duplication cyst in a 58-year-old man who sustained blunt trauma in a fall down stairs. a Reformatted sagittal contrast-enhanced CT shows circumferential wall thickening of [insightsimaging.springeropen.com]
- El Salvador
MurraSaca YouTube El Salvador Atlas Endoscopic Arts Endoscopic Presentations Email El Salvador Pictures Video Endoscopic Sequence 1 of 2. Duodenal Diverticula. A large duodenal diverticular cavity can be seen in the lower right aspect of the image. [gastrointestinalatlas.com]
Gastrointestinal
- Nausea
A 34-year-old woman presented with epigastric pain, nausea, and dyspepsia. [ncbi.nlm.nih.gov]
Intense abdominal pain, nausea, and fever are typical signs of diverticulitis and should be reported to a doctor right away. [wisegeekhealth.com]
The patient had been ill for five days with nausea, vomiting, and abdominal pain, particularly in the right upper quadrant. From the [jamanetwork.com]
- Epigastric Pain
A 34-year-old woman presented with epigastric pain, nausea, and dyspepsia. [ncbi.nlm.nih.gov]
Clinical History A 50-year-old female patient presented to the emergency department with sudden onset epigastric pain and vomiting. The patient revealed tenderness and localized peritonitis in the epigastric region. [eurorad.org]
It has been on the bottom differential for chronic epigastric pain, abdominal bloating, nausea, and hyporexia, yet, almost 90% are asymptomatic. [hindawi.com]
While the vast majority of patients are asymptomatic, patients with diverticulitis usually present with epigastric pain, nausea and vomiting. [radiopaedia.org]
pain, early saciety, nausea or vomiting. 3,5 Less commonly, IDD may complicate with gastrointestinal bleeding, 1,3,4 pancreatitis or duodenal obstruction. 3 Endoscopic appearance may be challenging: IDD may be collapsed and pass unnoticed, a long sac [elsevier.es]
- Dyspepsia
A 34-year-old woman presented with epigastric pain, nausea, and dyspepsia. [ncbi.nlm.nih.gov]
Be cautious about recommending surgery for patients who have a diverticulum and vague GI symptoms (eg, dyspepsia). Click here for Patient Education [merckmanuals.com]
91 year-old woman with dyspepsia, anemia and occult gastrointestinal bleeding. Upper endoscopy demonstrated duodenitis, deformity of the bulb suggesting prior ulcer disease, and small diverticula. [endoatlas.com]
Musculoskeletal
- Fracture
Abdominal subcutaneous emphysema (short arrows) secondary to multiple rib fractures and pneumothorax Vascular pathologies Hematomas essentially affect the second and third part of the duodenum [7]. [insightsimaging.springeropen.com]
- Contusion
Duodenal contusions and hematomas may manifest as a hyperattenuating, thickened duodenal wall; intramural gas; and fluid in the retroperitoneum or stranding of the peripancreatic fat as a result of mural haemorrhage (Fig. 21). [insightsimaging.springeropen.com]
Neurologic
- Asthenia
Case report We report the case of an 80-year-old woman who presented to the Emergency Room (ER) with asthenia of a four-day duration associated first with melena and then overt rectorrhage and coffee-ground vomiting. [scielo.isciii.es]
Workup
This report focuses on the significance of rare congenital anomalies of the duodenum (e.g., duplication cyst, intraluminal diverticulum) during the diagnostic workup of recurrent pancreatitis in children. [ncbi.nlm.nih.gov]
Laboratory workup showed leukocytosis of 17,200 with 86% left shift; serum liver and pancreatic function tests were normal. [hindawi.com]
Initial workup suggested leucocytosis (WBC 11000 K/uL), elevate lipase level (204 U/L) with normal total bilirubin (0.4 mg/dL) and LFTs. An abdominal ultrasound showed dilated CBD (9 mm) without evidence of gallstone. [shmabstracts.com]
Diagnostic workup is usually completed in the intensive care setting. Most patients stop bleeding, allowing elective surgery. Mesenteric angiography with infusion of vasoconstrictors can be used in persistent hemorrhage. [emedicine.medscape.com]
X-Ray
- Pneumoperitoneum
Under general anesthesia, a pneumoperitoneum was created. Four trocars were inserted into the peritoneal cavity for this intervention. [ncbi.nlm.nih.gov]
CT duodenal diverticulum wall thickening (possible) adjacent mesenteric or retroperitoneal fat stranding thickening of 2nd and 3rd parts of the duodenum rare findings: pneumoperitoneum and pneumoretroperitoneum Treatment and prognosis Conservative treatment [radiopaedia.org]
Pneumoperitoneum has also been reported in association with the use of argon gas to seal vascular lesions (6), hence therapy must always be delivered with extreme caution. [scielo.isciii.es]
Pneumoretroperitoneum and pneumoperitoneum following argon plasma coagulation for a bleeding duodenal diverticulum: a case report. South Med J 2010;103:175–177. PubMed Google Scholar Moyer MT, Bethards DM. [link.springer.com]
Laboratory
- Leukocytosis
On blood analysis, mild anemia and leukocytosis were noted. Abdominal CT showed a diverticulum in the fourth portion of the duodenum and pneumoretroperitoneum around this site. [jstage.jst.go.jp]
Laboratory results included moderate leukocytosis and a C-reactive protein of 9.6 mg/dL. [eurorad.org]
A 77-year-old, healthy female presented with right-sided abdominal pain with low-grade fever and leukocytosis. [cureus.com]
We describe two patients with duodenal diverticulitis who presented with abdominal pain, nausea, and leukocytosis. At the time of initial presentation, only one of the two patients was diagnosed correctly. [ajronline.org]
Table 2 Grades of severity in acute cholangitis Mild acute cholangitis Cholangitis with no criteria for grade II or III acute cholangitis II Moderately severe acute cholangitis Cholangitis with evidence of at least two of the following criteria Leukocytosis [endoscopy-campus.com]
Treatment
Herein, we report two cases of perforated duodenal diverticulum, one case managed with surgical treatment and one with conservative treatment. [ncbi.nlm.nih.gov]
She mentioned a medical history of Hashimoto disease under treatment. [bmcgastroenterol.biomedcentral.com]
Prognosis
However, it remains unclear whether excision of the diverticulum is preferred to biliodigestive anastomosis from the point of view of long-term prognosis. Subsequent surveillance is necessary. [ncbi.nlm.nih.gov]
Treatment and prognosis Complications Potential complications include 2, 3 duodenal diverticulitis hemorrhage perforation abscess formation biliary duct obstruction - Lemmel syndrome The major consideration and mimic of a duodenal diverticulum is that [radiopaedia.org]
Prognosis The prognosis is good even with complications. [emedicine.medscape.com]
Etiology
Conclusions: For elderly patient with recurrent acute pancreatitis without obvious etiology, ruling out a periampullary diverticulum as an etiology is worthwhile before making a diagnosis of idiopathic acute pancreatitis. [shmabstracts.com]
Conclusions :Anatomic causes of pancreatitis must be considered in the diagnosis of the etiology of acute pancreatitis. [pancreas.imedpub.com]
Though its exact etiology is not clear, diverticulum of duodenum usually occurs at weak spots in duodenal walls near the major and minor duodenal papillae. [pulsus.com]
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. [muni.cz]
Diagnosis is not easily made on ultrasonography, however, as our case illustrates, it should be suspected in the abscence of more common etiologies. [sages.org]
Epidemiology
Structures every chapter consistently to include Findings, Imaging Modalities, Clinical Presentation, Pathology, Incidence/Prevalence and Epidemiology, What the Referring Physician Needs to Know, Suggested Readings, and Selected Images to make reference [books.google.com]
Journal Journal ID (nlm-ta): Pan Afr Med J Journal ID (iso-abbrev): Pan Afr Med J Journal ID (publisher-id): PAMJ Title: The Pan African Medical Journal Publisher: The African Field Epidemiology Network ISSN (Electronic): 1937-8688 Publication date (Electronic [scienceopen.com]
Epidemiology of cancer of the small intestine. World J Gastrointest Oncol, 3 (2011), pp. 33-42 [8] T. Løtveit. The composition of biliary calculi in patients with juxtapapillary duodenal diverticula. [elsevier.es]
Systemic sclerosis Visceral myopathy Visceral neuropathy Epidemiology United States Duodenal diverticula are approximately five times more common than jejunoileal diverticula. [emedicine.medscape.com]
Pathophysiology
This show brings together some of the best boards-relevant content for physiology and pathophysiology from three innovative platforms: Physeo, InsideTheBoards, and Med School Phys. [podcasts.apple.com]
Pathophysiology The cause of this condition is not known. It is believed to develop as the result of abnormalities in peristalsis, intestinal dyskinesis, and high segmental intraluminal pressures. [emedicine.medscape.com]
Review article: The pathophysiology and medical management of diverticulosis and diverticular disease of the colon. Alimentary Pharmacology and Therapeutics. 2015;42:664. Pemberton JH, et al. [mayoclinic.org]
Pathophysiology: The cause of this condition is not known. It is believed to develop as the result of abnormalities in peristalsis, intestinal dyskinesis, and high segmental intraluminal pressures. Video Endoscopic Sequence 1 of 3. [gastrointestinalatlas.com]
Prevention
He had hypertension and dyslipidemia for several years, and was taking aspirin to prevent heart disease. CT and colonoscopy revealed a diverticulum in the third portion of the duodenum, rectal polyps, and internal hemorrhoids. [ncbi.nlm.nih.gov]
Before embolization, the microcatheter was flushed with 5% glucose solution to prevent polymerization of NBCA in the microcatheter. TAE was conducted with 0.3 ml of the NBCA–Lp mixture. [springerplus.springeropen.com]
In general, if you have diverticulosis but you’re not having a diverticulitis episode, a diet high in fiber will help prevent future flare-ups. [healthline.com]
Prevention To help prevent diverticulitis: Exercise regularly. Exercise promotes normal bowel function and reduces pressure inside your colon. Try to exercise at least 30 minutes on most days. Eat more fiber. [mayoclinic.org]
Recognition of the entity and its anatomic relationships to the ampulla of Vater is essential to the prevention of iatrogenic complications. [academic.oup.com]