Congenital duodenal obstruction associated with downs. Advanced duodenal neoplasia and carcinoma in familial. All but 1 web had a single aperture, and that patient had an imperforate wind sock web with a second eccentrically located aperture. Introduction we present the case of a 5monthold girl with duodenal web masquerading as pseudohypoaldosteronism pha. However, we have collected 14 cases over a period of only 3 years. The duodenum also undergoes a solid phase during this time. Windsock sign duodenal web radiology reference article. We describe a new fluoroscopic sign to aid in the diagnosis of an obstructing duodenal web and its attachment site. Duodenal atresiatandlers epithelial plug stage revisited. Congenital duodenal web in an adult pubmed central pmc.
It is the most laborious of all bariatric procedures so far, it involves performing a vertical sleeve gastrectomy and a. Pediatric duodenal atresia and stenosis surgery treatment. Congenital duodenal webs, as a cause of duodenal obstruction in adults, are rare. Duodenal web occurs in 1 out of 10 00040 000 births. The pdf file you selected should load here if your web browser has a pdf reader plugin installed for example, a recent version of adobe acrobat reader alternatively, you can also download the pdf file directly to your computer, from where it can be opened using a pdf reader. Textbook of gastroenterology, 4th edition surgery for duodenal ulcer part of chapter 70 surgery for peptic ulcer disease and postgastrectomy syndromes vagotomy in the treatment of duodenal ulcer the reduction of acid secretion by gastric denervation serves as the physiological basis of all modern surgical treatments for duodenal ulcer. The windsock sign is a typical appearance of a d uodenal web intraluminal duodenal diverticulum on upper gastrointestinal contrast series which consists of an intraduodenal barium contrastfilled sac that is surrounded by a narrow lucent line web or intraluminal mucosal diaphragm which is well demonstrated as the barium in the duodenum passes distal to the diverticulum. Duodenum grows rapidly, forming a cshaped loop ventrally. Endoscopic management of a duodenal web is feasible in children. The type i or membranous duodenal obstruction mucosal diaphragm, or web has been quoted to account for 0.
Demonstration of the web prior to operation is even rarer. Resection of a duodenal web using singleincision pediatric endosurgery resection of a duodenal web using singleincision pediatric endosurgery muensterer, oliver j hansen, erik n. Since first described by brdiczka in 1931 2, only 34 cases have been reported in which the diameter of the ulcer exceeded 2 centimeters 114. The pdf file you selected should load here if your web browser has a pdf reader plugin installed for example, a recent version of adobe acrobat reader. The failure of recanalization leaves behind a thin web with mucosa and submucosa layers only. The patient had gained 2 pounds at 4 week followup and remains asymptomatic six months after the procedure. The pdf file you selected should load here if your web browser has a pdf reader plugin installed for example, a recent version of adobe acrobat reader if you would like more information about how to print, save, and work with pdfs, highwire press provides a helpful frequently asked questions about pdfs alternatively, you can download the pdf file directly to your computer, from where it. More than 2 billion people in over 180 countries use whatsapp to stay in touch with friends and family, anytime and anywhere. A duodenal web was identified, partially resected, and the duodenotomy was repaired with a heinekemikulicz repair following confirmation of no additional duodenal obstructions. During an upper gi series of a neonate, a nasogastric tube was passed into an obstructed duodenum and barium injected. Anatomy of duodenum, duodenum structure, ppt of duodenum. Narrowed duodenum with web and edematous, friable duodenal mucosa proximally.
The tube, pressing on an obstructing web, caused dimpling of the duodenal contour at the attachment point of the web to the. Presence of an intrinsic and extrinsic pathology simultaneously is rare. Radiological emergency duodenal obstruction duodenal atresia intestinal atresia annular pancreas these keywords were added by machine and not by the authors. Unlike the duodenal atresia which typically presents itself with the double bubble sign immediately after birth, perforated duodenal web may seldom remain undiagnosed until beyond infancy. A duodenal web, which is one of the causes of duodenal obstruction, is a thin, round, partially permeable, web. Duodenal web presenting outside the neonatal period. A duodenal web, diaphragm or intraluminal diverticulum refers to a complete or incomplete obstruction at the duodenum due to a membranous web or intraluminal diverticulum. Maintenance of efficacy after duodenal jejunal bypass. Pdf duodenal web masquerading as pseudohypoaldosteronism. This is the first part of the bowel after the stomach.
Duodenal definition of duodenal by the free dictionary. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Type 1 duodenal atresia can also be managed by performing a simple duodenotomy with web excision. Pathogenesis of duodenal atresia can be explained by an embryological theory that involves persistent physiologic epithelial occlusion epithelial plug, first published in 1900. Congenital duodenal web causing proximal duodenal obstruction leading to gastroduodenal emphysema is a very rare.
Shortest, dilated and most fixed proximal part of small intestine. Postop upper gi showed rapid passage of contents without leak and a diet was started. Case presentation a 5monthold girl born to firstcousin parents was. One case of double duodenal web in this series emphasizes the need for mandatory checking of distal patency of gut at the time of surgery for bowel atresia. Of or pertaining to the duodenum, the first part of the small intestine. Endoscopic management of a duodenal web csurgeries. A case is presented showing diagnostic findings on a gastrointestinal gi series. Primary duodenal embryonal rhabdomyosarcoma in adults. Duodenal atresia and duodenal web are reported causes of intestinal obstruction in children with an incidence that ranges between 1 in 10,000 to up to 40,000 live births. This is a temporary file and hence do not link it from a website, instead link the url of this page if you wish to link the pdf file.
There is usually a small aperture at the center differentiating this from duodenal atresia. Congenital duodenal web leading to partial obstruction. Malrotation is known to be associated with other congenital obstructive anomalies including duodenal atresia, stenosis and duodenal web. This process is experimental and the keywords may be updated as the learning algorithm improves.
Retrocolic isoperistaltic gastrojejunostomy as an alternative to kimuras duodenoduodenostomy in low and very lowbirthweight babies of duodenal atresia. The obstructing lesion usually differs with the patients age. Only 32 cases of double duodenal webs have been reported in literature till date to the best of our knowledge out of which 2 were reported in adults 1623. Yousefa,b, aking saud bin abdulaziz university for health sciences ksauhs, college of medicinejeddah comj, saudi arabia b king abdulaziz medical city jeddah kamcjd, ministry of national guard, jeddah, saudi arabia article info article history. Embryology the hepatobiliary system and pancreas form during the third week of gestation, as the second portion of the duodenum gives rise to biliary and pancreatic buds at the junction of the foregut to the midgut. Although many surgeons prefer the former for duodenal atresia, there is evidence to suggest that the two procedures have similar outcomes. He then underwent repeat laparotomy with duodenotomy. Duodenal ulcer by moynihan, berkeley moynihan, baron, 18651936.
The patient was discharged on postoperative day 2 without narcotics. Minimally invasive resection of duodenal tumors cervoni. Tandlers developmental arrest theory has been accepted by the majority of recognized modern textbooks to date. These are rare nets of another part of the small bowel. Duodenal atresia is an intrinsic cause of duodenal obstruction. Delayed presentation of a duodenal web sciencedirect. The duodenal web was found to be preampullary in 20 of 22 patients and postampullary in 2. Duodenal web risks, symptoms and leading causes treato.
This rotation together with rapid growth of pancreas swings duodenum from. Alternatively, you can also download the pdf file directly to your computer, from where it can be opened using a pdf reader. To download the pdf, click the download link below. Duodenal atresia is the most common type of intestinal atresia. Duodenal definition, of or relating to the duodenum. Duodenal atresia duodenal stenosis, web springerlink. The patient is doing well eight months after excision of the webs and a finneys gastroduodenostomy. Justapapillar duodenal gastrointestinal stromal tumor. It is a retrospective case series of 18 patients with congenital duodenal webs, managed in our unit, between 1999 and 2011. Congenital duodenal obstruction associated with downs syndrome presenting with hematemesis. Learn about duodenal web from patients first hand experiences and trusted online health resources, including common treatments and medications. Congenital duodenal web leading to partial obstruction congenital duodenal web leading to partial obstruction radyoloji basvuru. The medical record of these patients was retrieved and analyzed for demographic details, clinical presentation, associated anomalies, and.
With a high amount of pressure proximal to the obstruction, peristalsis can cause the web to balloon distally, taking on the form of a wind sock 3, 10. Alternatively, you can also download the pdf file directly to your computer, from where it can be opened using a pdf. Anatomy of duodenum, duodenum structure, ppt of duodenum, power point presentation duodenum 1. It would appear that giant duodenal ulcer is an uncommon entity. Duodenal switch is a surgical technique for weight reduction and comorbid diseases control. Bypass procedures for duodenal atresia or stenosis include duodenoduodenostomy and duodenojejunostomy. There were 17 central apertures and 5 eccentric openings, with sizes ranging from 0. As stomach rotates 90 degrees in clockwise direction around its longitudinal axis to the left, duodenal loop rotates to the right.
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