The work analyses the results of examination and operative treatment of 69 patients with chronic duodenal ulcer and concurrent extravasal compression of the celiac trunk. The clinical signs characteristic of this combination are distinguished and it is shown that these patients have low indices of maximal acid production with a high frequency of duodenal reflux. Decrease of the hepatic and gastric blood flow was also found. It is suggested that such patients should be treated by combination of selective proximal vagotomy and decompression of the celiac trunk which is accomplished by exposure of the aorta over the celiac trunk and retrograde division of the median diaphragmatic ligament. The late-term results of the operation were analysed for follow-up periods of up to 10 years. Poor results were recorded in 6.2% of cases.
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Radiol Case Rep
March 2025
University of Maryland School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Division of Vascular and Interventional Radiology, Baltimore, MD, USA.
Splenic steal syndrome (SSS) post liver transplant is a potential cause of graft dysfunction in the setting of peripheral hepatic arterial bed resistance and redirection of blood flow to a dominant splenic artery resulting in reduction of hepatic arterial inflow. We report utilization of balloon occlusion of the proximal splenic artery as an objective measure to confirm the diagnosis of SSS in a patient with orthotopic liver transplant followed by successful treatment with proximal splenic artery embolization using Gelfoam and Amplatzer vascular plug. Written informed consent for the publication of this case report was obtained from the patient.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Upper Gastrointestinal Surgery Unit, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
The Arc of Bühler (AoB) is a rare anatomical variant in gastrointestinal vasculature where there is an aberrant anastomotic vessel between coeliac and superior mesenteric arteries. We present a rare case where AoB was noted intraoperatively to have haemodynamically significant flow in the context of coeliac artery stenosis, supplementing arterial supply to the hepatic artery proper via the gastroduodenal artery (GDA). An interpositional jump graft between the aorta and the GDA stump was created using the long saphenous vein, and flow was restored.
View Article and Find Full Text PDFClin J Gastroenterol
January 2025
University of Connecticut, Connecticut, USA.
Marginal ulcers are a common complication following Roux-en-Y bypass surgeries with an approximate incidence of 4.6%. The pathophysiology is complex and risk factors include smoking, nonsteroidal anti-inflammatory drugs (NSAIDs) use, Helicobacter pylori infection, and a larger pouch size.
View Article and Find Full Text PDFMorphologie
January 2025
Department of Digestive Surgery, Amiens Picardy University Hospital, 1, rondpoint du Pr-Cabrol, 80054 Amiens, France; Simplifying Care for Complex Patients, UR-UPJV 7518 SSPC, Clinical Research Unit, University of Picardie Jules-Verne, Amiens, France.
Introduction: The duodeno-pancreatic region is a highly vascularized area. The superior and posterior pancreaticoduodenal artery is a vessel primarily originating from the gastroduodenal artery. It exhibits rare anatomical variations, such as its emergence from the right branch of the hepatic artery, which we fortuitously identified during a cadaver dissection.
View Article and Find Full Text PDFAnn Surg Oncol
December 2024
Chongqing Key Laboratory of Intelligent Medicine Engineering for Hepatopancreatobiliary Diseases, Chongqing General Hospital, Chongqing University, Chongqing, China.
Background: Laparoscopic radical antegrade modular pancreatosplenectomy combined with celiac axis resection and portal vein reconstruction is a new procedure for the treatment of pancreatic cancer. This surgical technique may offer patients with pancreatic cancer involving the portal vein and celiac axis an opportunity for radical surgical resection. We aim to evaluate the short- and long-term efficacy and describe the surgical details of this technique.
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