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At least 37 records · Page 2Linked to original sources
PubMed1989

Adenocarcinoid tumor of the periampullary region: a novel duodenal neoplasm presenting as biliary tract obstruction.

An adenocarcinoid tumor of the duodenum, similar to those arising in the appendix, is reported. The tumor presented as a periampullary mass causing pancreaticobiliary obstruction. The microscopic features were typical of adenocarcinoid with diffuse infiltration of mucosa, submucosa, and smooth muscle by tubuloglandular structures lined by enteroendocrine and goblet cells. Signet ring cells were also present. It is desirable to distinguish adenocarcinoids from adenocarcinomas and typical carcinoids in this setting as, by analogy with appendiceal tumors, adenocarcinoids may be expected to have an intermediate prognosis.

Adenocarcinoma↗
PubMed2005

Duodenal diverticulum mimicking a cystic pancreatic neoplasm.

Duodenal diverticula occur very commonly, with a prevalence as high as 22%. They are most frequently located in the second or third portions of the duodenum, and by nature of their proximity to the head of the pancreas, can be mistaken for cystic pancreatic neoplasms by diagnostic imaging. Patients with presumed cystic neoplasms of the pancreas often receive pancreaticoduodenectomies, which at high volume medical centres carry mortality and morbidity rates of 2-4% and 29-44%, respectively. Although most duodenal diverticula are recognized in single or repeat CT scans by the presence of air or contrast medium within the diverticula, we present a case in which serial CTs failed to yield any clue to the diverticulum's true nature and pancreaticoduodenectomy was performed. For presumed cystic lesions adjacent to the duodenum, barium studies, endoscopy, and/or endoscopic ultrasound-guided aspiration should therefore be pursued in addition to all available CT evidence prior to surgery.

Aged↗
PubMed2005

Duodenal cancer arising from the remaining duodenum after pylorus-preserving pancreatoduodenectomy for ampullary cancer in familial adenomatous polyposis.

We herein report a rare occurrence of duodenal cancer arising from the remaining duodenum after pylorus-preserving pancreatoduodenectomy for ampullary cancer in familial adenomatous polyposis (FAP). In this patient, proctocolectomy and ileoanal anastomosis for FAP had been performed 11 years earlier. During the current admission, the patient was diagnosed with adenocarcinoma in the Vater's ampulla using imaging and pathological examinations. In addition, a pylorus-preserving pancreatoduodenectomy was performed. The tumor was a well-differentiated tubular adenocarcinoma and no other polyps were identified in the duodenum by pathological examination. However, 1 year after surgery, a polypoid lesion measuring 15 x 15 mm was indicated in the remaining duodenum by endoscopic surveillance. This lesion was completely resected by endoscopic mucosal resection and the resected specimen revealed well-differentiated tubular adenocarcinoma in an adenomatous lesion. This report suggests that resection of the total duodenum is essential for duodenal neoplasms in FAP to prevent a recurrence in the remaining duodenum.

Adenocarcinoma↗
PubMed2006

Current management of pancreatic fistula after pancreaticoduodenectomy.

BACKGROUND: Pancreatic fistula (PF) is a major and serious complication following pancreaticoduodenectomy (PD). The purpose of this study was to outline our management of PF after PD. METHODS: A retrospective review of a prospectively collected database of 396 patients undergoing PD for various indications at Loyola University Medical Center and Hines Veterans Administration Hospital from July 1, 1990, to December 31, 2005. Patients were divided group 1 (no PF) and group 2 (PF). Each group was compared regarding preoperative, intraoperative, and postoperative outcomes. RESULTS: Of the patients included in the study, 65 patients (16%) developed a PF. PF was more common after PD for ampullary neoplasms (28%), duodenal neoplasms (35%), and serous cystic neoplasms (44%), and was uncommon after PD for pancreatic cancer (6%). Associated complications with PF was 51% when compared with patients with no PF (21%; P </= .001). Duration of hospital stay was 16 days in PF versus 9 days in no PF (</=.001). Intraoperative blood loss was greater in the PF versus no PF group (P = .01). Clinically serious postoperative complications in the PF versus no PF group were mortality (P = .03), intraabdominal abscess (P </= .001), wound infection (P </= .001), hemorrhage (P = .01), cardiac (P </= .001), bile leak (P </= .001), and reoperation (P = .02). Of the 62 surviving patients with PF, 36 (58%) were treated with maintenance of oral diet, 25 (40%) with parenteral nutrition, and 1 (1.6%) required surgery for closure of PF. CONCLUSIONS: PF is a serious complication after PD and is associated with substantial mortality and other complications. The majority of patients with PF can be managed conservatively with either maintenance of oral diet or parenteral nutrition until closure of the PF.

Aged↗
PubMed1988

Obstructing plasmacytoma of the duodenum: first manifestation of relapsed multiple myeloma.

A patient with an obstructing, annular duodenal neoplasm is described. Percutaneous fine needle aspiration biopsy, and biopsy performed through an endoscope, confirmed that the lesion was an extramedullary plasmacytoma. The patient had been in clinical remission from multiple myeloma for the preceeding 13 months. Radiation therapy resulted in cessation of symptoms including gastrointestinal blood loss. After 5 months, recurrent obstructive symptoms and melena led to surgical extirpation of the tumor, with relief of all symptoms.

Aged↗