Although duodenal perforation is currently an infrequent complication of medical procedures, its incidence in the future predictably will increase as endoscopic treatment of duodenal neoplasms becomes more frequently used. In some cases, duodenal perforation is difficult to treat even surgically. We report here a novel technique called 'triple-tube-ostomy' for the treatment of iatrogenic duodenal perforation. Since November 2009, there have been three cases of iatrogenic perforation of the duodenum, due to various causes, which we have treated with our novel technique. The main principles of the technique are biliary diversion, decompression of the duodenum, and early enteral nutrition. All patients who underwent the triple-tube-ostomy procedure had good postoperative courses, with few complications. The novel surgical technique we describe in this report is safe, reliable, easy to learn and perform, and led to a good postoperative course in all cases where we performed it.
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http://dx.doi.org/10.1159/000335742 | DOI Listing |
Cureus
November 2024
Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, IND.
Duodenal perforation often presents as an acute onset of abdominal pain and potential complications such as systemic infection, multiple organ system failure, and even death. It can result from various causes, including peptic ulcer disease (PUD), trauma, malignancies, and infections. Prompt diagnosis and timely intervention are critical for better outcomes, though mortality can be high, particularly in delayed cases.
View Article and Find Full Text PDFSci Rep
December 2024
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
The morphology of the major duodenal papilla (MDP) plays a crucial role in the selection of the cannulation technique. Primary needle-knife fistulotomy (pNKF) is an advanced cannulation technique is getting more popular because of the lower risk of post-ERCP pancreatitis (PEP). However, few studies have explored the impact of MDP morphology on pNKF outcomes.
View Article and Find Full Text PDFCureus
November 2024
Accident and Emergency, Pilgrim Hospital, United Lincolnshire Hospitals Trust, Boston, GBR.
Epigastric pain and vomiting are common presentations associated with various causes of acute abdomen. Acute abdomen encompasses a range of different pathologies, with epigastric pain narrowing the differential diagnosis to conditions such as pancreatitis, bowel obstruction, acute cholecystitis, gastritis, acute coronary syndrome (ACS), and peptic ulcer disease, such as gastric ulcers and duodenal ulcers with/without perforation. This is a case of a male patient in his 80s who came to the emergency department with symptoms of generalized abdominal pain, vomiting, and constipation.
View Article and Find Full Text PDFCureus
November 2024
Department of General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR.
Trichobezoar or hairball in the proximal part of the gastrointestinal tract is a rare condition that occurs mainly in young and adolescent females. Since human hair is resistant to digestive enzymes and resistant to peristalsis, it easily accumulates between the folds of the mucosa. Over time, food and mucus accumulate within the hair, forming a compact mass that fills almost the entire lumen.
View Article and Find Full Text PDFGan To Kagaku Ryoho
December 2024
Dept. of Surgery, Owase General Hospital.
A 61-year-old woman underwent an open right hemicolectomy for perforated ascending colon cancer. Later, the patient underwent R2 surgery for duodenal invasion. Chemotherapy was initiated with mFOLFOX6 and panitumumab post-surgery.
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