Comparative study of CT and pathological findings in Brunner’s gland adenoma / 实用放射学杂志

Objective To investigate the imaging findings and key diagnostic points of Brunner’s gland adenoma on CT.Methods The CT imaging findings and pathological features of 9 cases of Brunner’s gland adenoma confirmed by pathology were retrospec-tively analyzed,including the lesions number,site,size,shape,margin,density and the enhancement pattern.Results Of the 9 ca-ses,1 case located in the antrum and 8 cases in the duodenaum [6 cases in the duodenal bulb (75%)and 2 in the papillary (25%)]. Of the 6 cases of duodenal lesions,3 were found at the anterior wall and 3 at the posterior wall.Except 1 case which complicated with enteritis and had an obscure margin,the other 8 cases were clear margined ,and were round or nodular in shape.The maximum size of tumors ranged 1 5-68 mm in diameters (mean 35.0 mm ± 1 6.2 mm).The density of tumors was homogeneous on CT scan without necrosis or hemorrhage.In the arterial phase after administration of contrast agent,the lesions were similar to the adjacent intestinal wall enhancement,and mucosal annular enhancement (halo sign)showed in 6 cases,and the dot-shape non-enhancement area within the lesion (black star sign)showed in 5 cases,and the thickening or tortuous enhanced blood vessel showed in 6 cases.In the venous phase,9 cases were progressive enhancement,and the “black star sign”or “the black line sign”showed more clearly in 5 cases.In the pathology,the lesions were polypoid-like,solid or cystic.Under the microscope,the hyperplasic Brunner’s glands were covered with normal duodenal mucosa and separated by bundles of smooth muscle cells with dilated duct,cyst,and adipose cells,1 case with atypical hyperplasia of the glandular epithelium and 1 case with ectopic pancreas.Conclusion There are some spe-cific CT imaging features in Brunner’s gland adenoma,which is of important clinical value in accurate preoperative diagnostic.

Study of responsible arteries of duodenal ulcer hemorrhage and the significance of transcatheter arterial embolization / 实用放射学杂志

Objective To study the responsible arteries of duodenal ulcer hemorrhage and the significance of transcatheter arterial embolization.Methods There were 1 7 patients of massive bleeding of duodenal ulcer,in which 1 6 patients were diagnosed and 8 ca-ses were treated by endoscope initially.DSAs were performed at gastr-oduodenal arteries or their ramus in all patients.DSA signs were analysed by two salted docters together.At first the responsible ar-teries for duodenal ulcer hemorrhage were affirmed,and then endo-vascular embolization was performed.Results The responsible arteries for duodenal ampulla ulcer hemorrhage were the ascending duodenal artery(ADA)、the pancreaticoduodenal trunk(PDT)、the supraduodenal artery(SDA)and the retroduodenal artery (RDA).The responsible arteries for descendant duodenum ulcer hemorrhage were the anterior superior pancreaticoduodenal artery (ASPDA)and the posterior superior pancreaticoduodenal artery(PSPDA).The positive rate of bleeding that showed the signs of bleeding was 100%,the s-uccess rate of the operations was 100%,the complete efficiency ra-te of hemostasis was 88.2%,the par-tial efficiency rate of hemostas was 1 1.8%.Conclusion The responsible arteries of duodenal ulcer hemorrhage are multiples,which is important for guiding transcatheter arterial embolization of the responsible arteries of duodenal ulcer hemorrhage accurately.

Adenocarcinoma de duodeno: relato de caso / Adenocarcinoma of the duodenum: a case report

Os adenocarcinomas de duodeno são processos neoplásicos extremamente raros e, portanto, pouco documentados na literatura médica. Nesta patologia, seus vagos e inespecíficos sintomas clínicos acabam por induzir, tanto ao médico quanto ao paciente, outros diagnósticos diferenciais benignos. Fora através dos adventos da video endoscopia e da radiologia que estes casos, mesmo que raros, começaram a ser relatados e descritos. É sabido hoje que a alternativa de cura em potencial para tal patologia é obtida através de cirurgia, em que o prognóstico vem se mostrando mais favorável àqueles pacientes sem comprometimento linfonodal. O caso por nós a ser relatado refere-se a um homem de 66 anos encaminhado para realização de endoscopia digestiva alta para investigação de anemia que resultou no diagnóstico clínico desta morbidade e posterior tratamento através de duodeno pancreatectomia em dupla alça com preservação pilórica.

Adenocarcinoma primário de duodeno / Adenocarcinoma of duodenum

Primary adenocarcinoma of the duodenum is an extremely rare disease, and represents only 0.35 percent of all gastrointestinal malignancies. Early detection of the disease may be difficult because of the absence of pathognomonic symptoms. The authors relate one case of a adenocarcinoma of the duodenum in a 61-year-old white man with a history of abdominal pain for a six-month period, associated with postprandial fullness, vomiting and weight loss. Contrasted x-ray and computerized tomography showed a tumor in the fourth segment of the duodenum, with partial obstruction of the lumen. Histological study revealed a moderate differentiated adenocarcinoma. Treatment consisted of resection of the fourth portion of duodenum. The authors comment on the most important aspects of this pathology.

Esophagus, Stomach & Intestine; A Case of the Cervical Carcinoma Involving the Second Portion of the Duodenum / 대한소화기내시경학회지

In Korea, careinoma of the cervix is the most common malignancy in women annually affecting 25 per every 100,000 female. The widespread use of the Papanicolaou smear has resulted in earlier detection of the tumor and a reduction in the number of patients with advanced disease, but the incidence of cervix. carcinoma is still the fifth most common malignancy in the world. Cervical carcinoma spreads to the small bowel primarily by direct extension from involved lymph nodes, most commonly from peraaortic or mesenteric nodes to the serosa of the bowel. But, the involvement of small bowel by cervical carcinoma is so rare, and shows a maximum incidence of small bowel involvement of less than 1.5%. We report a patient with squamous cell carcinoma of the cervix metastases to the second portion of the duodenum in whom the diagnosis was made by endoscopic biopsy of the lesion.

Analysis on the Lingnal Pictures of 255 Casese of Perforation of the Stomach and Duodenum / 中医杂志

Analysis on the cases demonstrated that the changes in their tongues possess some characteristics and changing regularity. As compared with the related ailments, indices of the proper and coating of the tongue presented very significant differeces. thus, the application of lingual picture in the diagnosis of perforation of the stomach and duodenum becomes feasible.