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2.1
Duodenal Stenosis
Duodenum Steis

Presentation

Our patient presented at the age of 5 months, outside of the immediate neonatal period, and with the atypical presenting sign of hematemesis. [ncbi.nlm.nih.gov]

Entire Body System

  • Pain

    This study supports the view that duodenal stenosis is caused by severe intramural duodenal inflammation and suggests that a pancreaticoduodenectomy may be required for relief of pain. [ncbi.nlm.nih.gov]

    Pain One of the earliest signs of a blockage in the duodenum is pain in the abdomen. Initially the pain is intermittent, SmallBowelObstruction.net reports, and feels like abdominal cramping. [livestrong.com]

    Abstract To the editor: Patients with excessive type V hyperlipoproteinemia develop several forms of abdominal pain that can be caused by three mechanisms: painful and tender spleen and liver, intestinal dysfunction, and pancreatitis (1-3). [annals.org]

    Some of the released mediators such as increase the sensitivity to pain [wikivisually.com]

  • Asymptomatic

    Two year follow-up reveals the patient to be asymptomatic without recurrence of pancreatitis. [ncbi.nlm.nih.gov]

    Further abstracts you may be interested in #40 Clinical and prognostic implications of the genetic diagnosis of hereditary NET syndromes in asymptomatic patients Introduction: Neuroendocrine tumors (NETs) are rare neoplasms, heterogeneous, and with variable [enets.org]

  • Weight Loss

    The patient was admitted to hospital presenting anorexia, repeated alimentary vomiting, epigastric pain, and weight loss. Objective clinical examination upon admission: clapotage à jeun is present, triggered by tapping the epigastric region. [ncbi.nlm.nih.gov]

    We report herein the case of a 22 year-old male in whom Crohn disease was diagnosed due to weight loss in relation with a stenosis of the first and second parts of the duodenum. A gastrojejunostomy was performed with a good subsequent result. [archive-ouverte.unige.ch]

    They had greater weight loss and more metabolic disturbances at readmission for surgery. One infant in the late diagnosis group died. [nature.com]

    CASE REPORT A full-term male newborn infant was admitted on the 2nd day of life to the neonatal intensive care unit with intermittent bilious vomiting, abnormal weight loss, and upper abdominal distension. [journals.lww.com]

    Features of weight loss and volume depletion should be looked for in a suspected case of GOO. [tropicalgastro.com]

  • Fever

    We report a case with an unusual pathogenic mechanism: sudden ileus due to food impaction.A 15-month-old boy was admitted to our institution with a history of recurrent vomiting and diarrhea for 7 days and fever for 2 days. [ncbi.nlm.nih.gov]

    In contrast, chronic inflammation may lead to a host of diseases, such as hay fever, periodontitis, atherosclerosis, rheumatoid arthritis, Inflammation is therefore normally closely regulated by the body. [wikivisually.com]

    Survival time Additionally, 1 patient exhibited cough and fever, which, according to a CT scan, were considered to be symptoms of aspiration pneumonia. [spandidos-publications.com]

    Also she had dry eyes, dry mouth, muscle weakness and intermittent pain in large joints, and low grade fever. [cyberleninka.ru]

  • Surgical Procedure

    All surgical procedures of balloon dilatation were performed under direct gastroscopic vision. [ncbi.nlm.nih.gov]

    Prior to surgery hydroelectrolitique reequlibration is needed The surgical procedure depends on the malformation Diaphragm: longitudinal duodenectomy Annular pancreas: diamond shaped duodeno-duodenal anastomosis Ladd's syndrome: resection and decompresion [pathologyreviewer.blogspot.com]

    Once the child is stabilized, a surgical procedure is performed to bypass the obstruction. We performed the duodenojejunostomy anastomosis for the first sister and duodenoduodenostomy for the second sister. [saudisurgj.org]

    Also it signifies the extended value of minimal invasive surgery in children to perform a thorough inspection of abdomen in presence of symptoms unrelated to known cause or previous surgical procedures. [file.scirp.org]

    Laparoscopic Laparoscopic pyloromyotomy has been demonstrated as a safe approach with results at least equivalent to the open surgical procedure and may result in decreased time to full feeding, less perioperative pain, and a superior long-term cosmetic [basicmedicalkey.com]

Respiratoric

  • Aspiration

    However, the patient continued to have high-bilious aspirates. A paediatric surgical opinion was requested. [casereports.bmj.com]

    […] distention in the eigastric region Normal meconium if the obstruction is superior to Vater's ampulla Acolic mucous secretion if the obstruction is inferior to Vater's ampulla Spirt vomiting, in high amounts Sings of dehydration: depressed fontanelle Gastric aspiration [pathologyreviewer.blogspot.com]

    His initial post-operative period was uneventful and then he had nasogastric tube aspirates ranging from 400 to 750 ml in the following few days. [jpss.eu]

    Aspiration via a nasogastric (NG) tube of more than 20 mL of gastric contents in a newborn suggests intestinal obstruction, as normal aspirate is less than 5 mL. 41 For patients with stenosis, the diagnosis is often delayed until the neonate has started [clinicalgate.com]

    Other symptoms include saliva excess, failure to thrive and recurrent respiratory infections due to aspiration [ 4, 5, 6 ]. [jbsr.be]

  • Pneumonia

    There were 10 late deaths (range, 3 months to 14 years) attributable to complex cardiac malformations (5), central nervous system bleeding (1), pneumonia (1), anastomotic leak (1), and multisystem organ failure (2). [ncbi.nlm.nih.gov]

    […] with early manifestation Cardio-tuberosity malposition Treatment of duodenal atresia atresia and duodenal stenosis Without treatment dudenal atresia and stenosis leads to severe complications: impairment of narmal groeth and development, aspiration pneumonia [pathologyreviewer.blogspot.com]

    Survival time Additionally, 1 patient exhibited cough and fever, which, according to a CT scan, were considered to be symptoms of aspiration pneumonia. [spandidos-publications.com]

    In some instances, duodenal stenosis goes unrecognized for long periods, leading to recurrent episodes of vomiting, failure to thrive, and aspiration pneumonia. [journals.lww.com]

    However, a Complete Blood Count (CBC) obtained for work-up of pneumonia during the visit revealed a Hb of 7.4 g/dl, which had dropped by 2.3 g/dl over the past two months. 2 units of packed RBCs were transfused with a subsequent increase in Hb to 8.7 [benthamopen.com]

Gastrointestinal

  • Vomiting

    He was initially treated for acute gastroenteritis, but vomiting resumed after starting oral ingestion. [ncbi.nlm.nih.gov]

    If the defect is located proximal to the major duodenal papilla, nonbilious vomiting occurs, whereas a defect occurring distal to the papilla causes bilious vomiting. [amboss.com]

  • Abdominal Pain

    We report three patients with chronic alcoholic pancreatitis who developed duodenal stenosis and intractable abdominal pain. In two patients, the stenosis was caused by severe inflammation of pancreatic tissue within the wall of the duodenum. [ncbi.nlm.nih.gov]

    Abstract To the editor: Patients with excessive type V hyperlipoproteinemia develop several forms of abdominal pain that can be caused by three mechanisms: painful and tender spleen and liver, intestinal dysfunction, and pancreatitis (1-3). [annals.org]

  • Bilious Vomiting

    If the defect is located proximal to the major duodenal papilla, nonbilious vomiting occurs, whereas a defect occurring distal to the papilla causes bilious vomiting. [amboss.com]

    Preampullary lesions with non-bilious vomiting simulating gastric outlet obstruction has been reported recently [1]. [jpss.eu]

    Case report – The patient is 2 year old aged girl with persistent non-bilious vomiting. She was vomiting several times a week, and over the ten days prior to presentation as many as several times a day. [cejpaediatrics.com]

    Abdominal distention with bilious vomiting is observed within the first 24 hours after birth. [aafp.org]

    […] bowel distal to the obstruction No oral or rectal contrast is usually needed to diagnose duodenal atresia Double bubble may also be seen on prenatal ultrasounds Differential Diagnosis Malrotation with Ladd’s bands Bilious vomiting within 24 hours of [learningradiology.com]

  • Nausea

    A 61-year-old woman was admitted to our hospital complaining of abdominal fullness, epigastralgia, nausea, and vomiting. [ncbi.nlm.nih.gov]

    Nausea and Vomiting Obstruction of the duodenum can also cause patients to become nauseated and vomit. [livestrong.com]

    Vomiting with intense nausea and dull stomach pain is more likely with gastroenteritis. [telefot.eu]

  • Recurrent Vomiting

    Most patients are diagnosed during the neonatal period based on recurrent vomiting, but some cases develop symptoms at an older age. [ncbi.nlm.nih.gov]

    Case Report A 10-month-old male infant presented to pediatric emergency department with history of recurrent vomiting and failure to thrive. His height and weight was below third percentile for his age. [file.scirp.org]

    Duodenal stenting was suggested when recurrent vomiting was observed in the absence of features suggestive of peritoneal carcinomatosis, and was confirmed using imaging methods. [spandidos-publications.com]

    Succussion splash, demonstrated by auscultation of a “splash” reflective of retained gastric material, if noted more than four hours after a meal is suggestive of GOO with a sensitivity of 50%. [23 ] Investigations Patients with recurrent vomiting may [tropicalgastro.com]

Cardiovascular

  • Heart Disease

    Associated with congenital heart disease in 17% to 33% of cases. Echocardiography should be performed. Polyhydramnios rarely develops before 24 weeks’ gestation but can contribute to preterm labor. [mhmedical.com]

    Other anomalies include malrotation of the small bowel, esophageal atresia, congenital heart disease, imperforate anus, small bowel atresia, biliary atresia, annular pancreas, and renal anomalies (Auringer and Sumner 1994; Bailey et al. 1993). [europeanmedical.info]

    About 10% of duodenal webs found in childhood are associated with other congenital conditions such as trisomy 21, intestinal malrotation, situs inversus, congenital heart disease, or annular pancrease[8]. [ghrnet.org]

    cystic fibrosis, malrotation, Down syndrome, anorectal and vertebral anomalies, neural tube defects, congenital heart disease, and other GI atresias. 56, 69, 70 Methylene blue, previously used for amniocentesis in twin pregnancies, has been implicated [clinicalgate.com]

    disease and tracheal esophageal fistula. 8 Growth retardation or prematurity may occur in one-third or more of the patients without chromosomal disorders. [nature.com]

  • Hypotension

    Depending on severity, anemia can manifest as postural hypotension, tachycardia, pallor, koilonykia, decreased muscle strength, headaches and/or confusion. [benthamopen.com]

    Bradycardia, hypothermia, apneic spells and hypotension are later signs of progressive deterioration. Abnormal hemorrhage, hyperbilirubinemia and oliguria are late findings. [aafp.org]

Psychiatrical

  • Hunger

    Epigastric pain often masquerades as hunger. Acid Reflux One Month After Prednisone Acid Reflux During Exercise with Does Lemon Juice Bother Acid Reflux and Food Help Acid Reflux learn Acid reflux disease. [telefot.eu]

Neurologic

  • Lethargy

    Physical findings include erythema and edema of the abdominal wall, absence of bowel sounds, abdominal distention, visible and/or palpable loops of the bowel, guarding and lethargy. [aafp.org]

Workup

The diagnostic preoperative workup should include a plain abdominal radiograph, upper and/or lower gastrointestinal contrast studies, and ultrasonography (1). [journals.lww.com]

Treatment

Endoscopic treatment is feasible in these patients. The long-term outcomes of endoscopic therapy need to be compared with surgical treatment. [ncbi.nlm.nih.gov]

At that time it was Germany's first medical institution specializing in the treatment of diabetes. [bookinghealth.com]

742 Laparoscopic Treatment of Nonpalpable Testis 753 Transperitoneal Laparoscopic Treatment of Varicocele 759 Oneport Retroperitoneoscopic Varicocelectomy in Children and Adolescents 765 Laparoscopy in Functional Ovarian Cysts in Neonates 771 Laparoscopy [books.google.de]

Prognosis

This classification generally guides prognosis and therapy (see the image below). Classification of jejunoileal atresias. [emedicine.medscape.com]

Prevention, and Complications Prognosis full recovery is expected after surgical correction Prevention no preventive measures are available at this time Complications without treatment, condition is lethal Please rate topic. [medbullets.com]

If left untreated, it is fatal Prognosis will depend on the presence of associated cardiac, tracheo-esophageal, anal, renal, or skeletal abnormalities (VATER) Double Bubble Sign. [learningradiology.com]

Neuroendocrine tumors (NETs) are characterized by having behavior and prognosis that depend upon tumor histology, primary site, staging, and proliferative index. [scinapse.io]

Etiology

Necrotizing enterocolitis was the most common (6/9) etiology of stricture. Ten of 11 patients did not require subsequent operative management although 3 children required further dilatations. [ncbi.nlm.nih.gov]

Etiology Multiple theories regarding the etiology of jejunoileal atresia have been studied in many animal models (eg, puppies, ewes, rabbits, and chick embryos). [22, 23, 24, 25, 26] Murine studies suggest that some forms of atresia may be hereditary [emedicine.medscape.com]

Early postoperative survival rates of greater than 90% should be expected. 7 – 11 Etiology Congenital duodenal obstruction can occur due to an intrinsic or extrinsic lesion. 12 The most common cause of duodenal obstruction is atresia. 7 This intrinsic [clinicalgate.com]

[…] called also Brunner's glands. duodenal reflux retrograde movement of duodenal contents, either into the stomach where it has been incriminated as a cause of vomiting and gastric hyposecretion, or into the pancreatic duct and parenchyma as a factor in the etiology [medical-dictionary.thefreedictionary.com]

To date, none of the theories proposed offers a definitive answer to the question of the etiology of HPS. [basicmedicalkey.com]

Epidemiology

References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

The anomalies are organized by anatomical system and presented in a consistent manner, including details of the clinical presentation, epidemiology, embryology, treatment and prevention for each anomaly. [books.google.de]

After an overview of pathogenesis, classification, and epidemiology of AIDS, chapters cover early cutaneous signs and symptoms, superficial and disseminated fungal and protozoal infections, bacterial and complex infections, venereal disease, cutaneous [books.google.es]

[…] during weeks 8-10 of development Results in stenosis of the duodenal passageway between the stomach and intestinal tract leads to gastric outlet syndrome Associated with Down syndrome (20-30% of DS cases) and other birth defects as with biliary atresia Epidemiology [medbullets.com]

[…] intravenously. [1] The definitive treatment for duodenal atresia is surgery (duodenoduodenostomy), which may be performed openly or laparoscopically. [6] The surgery is not urgent. [1] The initial repair has a 5 percent morbidity and mortality rate. [2] Epidemiology [en.wikipedia.org]

Pathophysiology

Pathophysiology Duodenal atresia occurs when recanalization of the closed duodenum fails to occur or occurs only partially during the embryonic period (usually between the 8 th –10 th week of gestation). [amboss.com]

Etiology/Pathophysiology: The ratio of duodenal atresia to duodenal stenosis is 4:1. The point of atresia is distal to the ampulla of Vater in 75-80% of patients. [virtualpediatrichospital.org]

Likewise, our understanding of the etiology and pathophysiology of duodenal obstruction and malrotation has been largely stagnant. [basicmedicalkey.com]

Double duodenal atresia or stenosis is less frequently reported. [6] Pathophysiology In 1900, Tandler described the traditionally accepted theory on the normal development of the duodenum. [7] The duodenum develops from the caudal part of the foregut [emedicine.medscape.com]

Gastric outlet obstruction (GOO) represents a clinical and pathophysiological consequence of any disease process which produces mechanical impediment to gastric emptying. [tropicalgastro.com]

Prevention

The anomalies are organized by anatomical system and presented in a consistent manner, including details of the clinical presentation, epidemiology, embryology, treatment and prevention for each anomaly. [books.google.de]

A loose overbridging duodenoduodenostomy was performed to prevent compression of the vessel. The cardiac anomalies were corrected, and he could eat unrestricted diets. [ncbi.nlm.nih.gov]

and Complications Prognosis full recovery is expected after surgical correction Prevention no preventive measures are available at this time Complications without treatment, condition is lethal Please rate topic. [medbullets.com]

[…] there could be multiple diaphragms and the downstream one may be missed due to non-dilation and therefore careful passage and withdrawal of balloon Fogarty or Foley catheter both ways proximally into the stomach and distally into the small bowel will prevent [casereports.bmj.com]

Food is blocked from passing through the intestine, which prevents normal feeding and intestinal function. Intestinal atresia and stenosis usually involve the small intestine, but can affect any part of the gastrointestinal tract. [chp.edu]

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2.1
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