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Fernandes DA, Boteon YL, Boteon APCDS, Sousa RMP, Martins DL, Penachim TJ, Barros RHDO, Martins RDCP, Costa LBED, Cazzo E, Gestic MA, Chaim EA, Caserta NMG. Tubulovillous adenoma of the duodenal papilla: radiological-endoscopic and anatomopathological correlation in the surgical proposal. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2020; 66:1190-1195. [PMID: 33027444 DOI: 10.1590/1806-9282.66.9.1190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/22/2020] [Indexed: 02/08/2023]
Abstract
Tubulovillous adenomas of the duodenal ampulla are rare neoplasms. The present report describes a case with radiological-endoscopic and pathological correlation in which the patient underwent duodenal pancreatectomy with good postoperative progression. With advanced imaging methods, especially magnetic resonance and endoscopic ultrasound, locoregional aspects and extraluminal, lymphovascular, and metastatic invasion have been increasingly discussed as contributors to therapeutic decision making. This progression improves lesion staging and is especially useful in selecting eligible candidates for endoscopic treatment.
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Affiliation(s)
- Daniel Alvarenga Fernandes
- Departamento de Radiologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Yuri Longatto Boteon
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
- Centre for Liver and Gastrointestinal Research, Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | | | - Rachid Marwan Pinheiro Sousa
- Departamento de Radiologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Daniel Lahan Martins
- Departamento de Radiologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Thiago José Penachim
- Departamento de Radiologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Ricardo Hoelz de Oliveira Barros
- Departamento de Radiologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Rita de Cássia Perina Martins
- Departamento de Anatomia Patológica, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Larissa Bastos Eloy da Costa
- Departamento de Anatomia Patológica, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Everton Cazzo
- Departamento de Cirurgia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Martinho Antônio Gestic
- Departamento de Cirurgia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Elinton Adami Chaim
- Departamento de Cirurgia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
| | - Nelson Marcio Gomes Caserta
- Departamento de Radiologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM- Unicamp), Campinas, SP, Brasil
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2
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Lubner MG, Menias CO, Johnson RJ, Gaballah AH, Shaaban A, Elsayes KM. Villous Gastrointestinal Tumors: Multimodality Imaging with Histopathologic Correlation. Radiographics 2018; 38:1370-1384. [PMID: 30059275 DOI: 10.1148/rg.2018170159] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Villous lesions are advanced adenomas that manifest most commonly in the colon; however, they can develop throughout the gastrointestinal tract. The duodenum is the most common small-bowel site of these lesions. Although in most cases these are isolated lesions that occur sporadically, patients with certain specific colorectal cancer syndromes, including familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, may develop multiple advanced adenomas. Villous lesions are important because although they are histologically benign, they may harbor dysplasia and have potential for malignancy. These characteristics make them a primary target for colorectal cancer screening with optical and virtual colonoscopy. However, these lesions can also be symptomatic and detected at diagnostic imaging when patients present for examination. They have characteristic features at a variety of imaging examinations, including barium fluoroscopy, CT, MRI, and endoscopic US. It is important for radiologists to be aware of these lesions, their potential morphologies, and their typical appearances at multimodality imaging. Although villous tumors can be detected at imaging and confirmed with biopsy, owing to limitations in identifying dysplasia and foci of malignancy with the above modalities alone and the potential for malignancy, referral for surgical resection of these lesions ultimately is required. ©RSNA, 2018.
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Affiliation(s)
- Meghan G Lubner
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792 (M.G.L.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (C.O.M.); Department of Diagnostic and Interventional Imaging, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Tex (R.J.J.); Department of Radiology, University of Missouri Healthcare, Columbia, Mo (A.H.G.); Department of Radiology, Health Sciences Center, University of Utah, Salt Lake City, Utah (A.S.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Christine O Menias
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792 (M.G.L.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (C.O.M.); Department of Diagnostic and Interventional Imaging, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Tex (R.J.J.); Department of Radiology, University of Missouri Healthcare, Columbia, Mo (A.H.G.); Department of Radiology, Health Sciences Center, University of Utah, Salt Lake City, Utah (A.S.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Rashad J Johnson
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792 (M.G.L.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (C.O.M.); Department of Diagnostic and Interventional Imaging, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Tex (R.J.J.); Department of Radiology, University of Missouri Healthcare, Columbia, Mo (A.H.G.); Department of Radiology, Health Sciences Center, University of Utah, Salt Lake City, Utah (A.S.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Ayman H Gaballah
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792 (M.G.L.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (C.O.M.); Department of Diagnostic and Interventional Imaging, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Tex (R.J.J.); Department of Radiology, University of Missouri Healthcare, Columbia, Mo (A.H.G.); Department of Radiology, Health Sciences Center, University of Utah, Salt Lake City, Utah (A.S.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Akram Shaaban
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792 (M.G.L.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (C.O.M.); Department of Diagnostic and Interventional Imaging, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Tex (R.J.J.); Department of Radiology, University of Missouri Healthcare, Columbia, Mo (A.H.G.); Department of Radiology, Health Sciences Center, University of Utah, Salt Lake City, Utah (A.S.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Khaled M Elsayes
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792 (M.G.L.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (C.O.M.); Department of Diagnostic and Interventional Imaging, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Tex (R.J.J.); Department of Radiology, University of Missouri Healthcare, Columbia, Mo (A.H.G.); Department of Radiology, Health Sciences Center, University of Utah, Salt Lake City, Utah (A.S.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.)
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3
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Anand U, Pandey MK, Priyadarshi RN, Kumar R, Chaudhary B. Large Tubullo-villous Adenoma of Duodenum Presenting as Gastric Outlet Obstruction. J Clin Diagn Res 2016; 9:PD03-4. [PMID: 26816945 DOI: 10.7860/jcdr/2015/14759.6946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 10/16/2015] [Indexed: 11/24/2022]
Abstract
Tubullo-villous adenoma of duodenum is a rare entity. These are potentially malignant tumours and therefore, complete excision is the treatment of choice. However, at times preoperative diagnosis could not be always achieved posing difficulty in choosing the optimal surgical method of excision. We report a 40-year-old male patient presented with vague upper abdominal pain and vomiting for last 6 months. His computed tomography and endoscopy demonstrated intraluminal polypoidal mass. Endoscopic biopsies were negative for malignancy. Local surgical excision with tumour free margin was performed and histology revealed tubullo-villous adenoma.
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Affiliation(s)
- Utpal Anand
- Consultant, Department of Gastro Surgery, Paras HMRI Hospital , Patna, Bihar, India
| | - Manish Kumar Pandey
- Consultant, Department of Gastro Surgery, Paras HMRI Hospital , Patna, Bihar, India
| | | | - Ramesh Kumar
- Consultant, Department of Gastroenterology, Paras HMRI Hospital , Patna, Bihar, India
| | - Binita Chaudhary
- Senior Resident, Department of Anatomy, AIIMS , Patna, Bihar, India
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4
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Suh CH, Tirumani SH, Shinagare AB, Kim KW, Rosenthal MH, Ramaiya NH, Baheti AD. Diagnosis and management of duodenal adenocarcinomas: a comprehensive review for the radiologist. ACTA ACUST UNITED AC 2014; 40:1110-20. [DOI: 10.1007/s00261-014-0309-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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5
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Izgur V, Dass C, Solomides CC. Best cases from the AFIP: villous duodenal adenoma. Radiographics 2010; 30:295-9. [PMID: 20083599 DOI: 10.1148/rg.301095053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Vitaly Izgur
- Departments of Diagnostic Radiology and Pathology, Temple University Hospital, 3401 N Broad Street, Philadelphia, PA 19140, USA.
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6
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Kitajima K, Bardier-Dupas A, Breton S, Rousseau G, Siksik JM, Vaillant JC, Hannoun L. Variant on Manifestation of Duodenal Metastasis 26 Years after Initial Diagnosis of Primary Cutaneous Melanoma. Case Rep Gastroenterol 2010; 4:93-99. [PMID: 21103234 PMCID: PMC2988904 DOI: 10.1159/000290383] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Malignant duodenal neoplasms are relatively rare, and the diagnosis is often delayed because of their vague and nonspecific symptoms. We report the case of a 79-year-old female who had a medical history of malignant melanoma of the cheek that had initially been diagnosed at 53 years of age. Work-up revealed severe stenosis of the duodenum caused by a large mass with ulceration at the tip of its mucosal surface. Tumor biopsy led to a histological diagnosis of extremely poorly differentiated carcinoma, but it was impossible to determine whether the lesion was a primary neoplasm or represented secondary involvement. Pancreatoduodenectomy was performed, and the surgical specimen showed a protuberant tumor in the nonampullary region of the second portion of the duodenum. Final diagnosis of metastatic duodenal melanoma was made by immunohistological examination. She is currently alive without recurrence 28 months after the surgical treatment.
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Affiliation(s)
- Kumiko Kitajima
- Department of Digestive and Hepato-Biliary-Pancreatic Surgery, Liver Transplantation Unit, Université Pierre et Marie Curie - Paris VI, Paris, France
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7
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Wei CJ, Chiang JH, Lin WC, Tiu CM, Chang CY. Tumor and tumor-like lesions of duodenum: CT and barium imaging features. Clin Imaging 2003; 27:89-96. [PMID: 12639773 DOI: 10.1016/s0899-7071(02)00494-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Neoplasms of the duodenum, either primary or secondary, are uncommon. However, imaging diagnosis for presurgical evaluation is extremely important due to complex regional anatomy. Computed tomography (CT) and barium-based double contrast examination (UGI series) are most frequently employed to evaluate the tumor invasion and intraluminal mucosal pattern. In this pictorial review, the CT and UGI series imaging features of benign and malignant duodenal tumors and tumor-like lesions are demonstrated and discussed.
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Affiliation(s)
- Chao-Jung Wei
- Department of Radiology, Taipei Veterans General Hospital, 201 Shih-Pai Road Sec 2, Pei-Tou District, Taipei 11217, Taiwan
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8
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Angelelli G, Ianora AA, Scardapane A, Pedote P, Memeo M, Rotondo A. Role of computerized tomography in the staging of gastrointestinal neoplasms. SEMINARS IN SURGICAL ONCOLOGY 2001; 20:109-21. [PMID: 11398204 DOI: 10.1002/ssu.1024] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Gastrointestinal neoplasms are very common diseases, and the first challenge for clinicians is to define the extent of the tumor in order to plan the best treatment. The role of computerized tomography in assessing this kind of patient is well established worldwide. This article reviews the capabilities and the limits of this imaging technique in the staging of the tumors of the digestive tract (liver, gallbladder, biliary tract, pancreas, esophagus, stomach, small bowel, and colon).
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Affiliation(s)
- G Angelelli
- Department of Radiology, University Hospital of Bari, Bari, Italy.
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9
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Hwang JI, Chiang JH, Yu C, Cheng HC, Chang CY, Mueller PR. Pictorial review: Radiological diagnosis of duodenal abnormalities. Clin Radiol 1998; 53:323-32. [PMID: 9630268 DOI: 10.1016/s0009-9260(98)80002-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This article depicts the radiological findings of many common gastrointestinal entities. Specifically, examples of disease processes that affect the stomach, gall bladder, small intestine, pancreas and colon are shown. In most cases there is correlation between ultrasound, computed tomography (CT) and fluoroscopic imaging. The major emphasis of the article, however, is to demonstrate classic barium imaging of a large number of gastrointestinal disease processes.
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Affiliation(s)
- J I Hwang
- Department of Radiology, Veterans General Hospital-Taipei and National Yang-Ming University, Taiwan, Republic of China
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10
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Buckley JA, Siegelman SS, Jones B, Fishman EK. The accuracy of CT staging of small bowel adenocarcinoma: CT/pathologic correlation. J Comput Assist Tomogr 1997; 21:986-91. [PMID: 9386295 DOI: 10.1097/00004728-199711000-00025] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Several studies have documented the use of CT in the evaluation of small bowel neoplasms, but few have addressed the CT staging of adenocarcinoma. We retrospectively correlated CT and pathologic staging to evaluate the accuracy of CT for staging small bowel adenocarcinoma using American Joint Committee on Cancer criteria. METHOD The preoperative CT scans of 15 patients with pathologically proven small bowel adenocarcinoma were analyzed. Two blinded readers separately interpreted extent of invasion, presence of lymphadenopathy, and distant metastases. Pathologic and CT staging were compared. RESULTS The overall accuracy of CT staging was 47% (14/30). The sensitivity of detection of mesenteric infiltration was 88%. The sensitivity and specificity for detection of distant metastases were 58 and 63% and for lymphadenopathy 75 and 20%, respectively. Errors occurred in patients with Crohn disease, adenomas, Peutz-Jegher syndrome, small bowel obstruction, and perforation and on suboptimal studies. CONCLUSION The accuracy of CT staging of small bowel adenocarcinoma is 47%. CT is highly sensitive but not specific for the detection of mesenteric infiltration and regional lymphadenopathy. Since spiral CT may offer improved detection of distant metastases and increased accuracy in the evaluation of patients with concomitant bowel disease, further research is needed to determine the maximal utility of CT in the staging of adenocarcinoma of the small bowel.
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Affiliation(s)
- J A Buckley
- Department of Radiology, Stanford University Medical Center, CA, USA
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11
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12
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Rueda O, Alvarez C, Vicente JM, Martel J, Escribano J. Quiz case of the month. Villous tumor of the duodenum. Eur Radiol 1997; 7:951-2. [PMID: 9264864 DOI: 10.1007/s003300050235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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13
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Affiliation(s)
- J H Small
- Department of Radiology, Addenbrookes Hospital Cambridge, UK
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14
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Arvanitakis M, Giavroglou C, Anastasiou A, Golobias G, Zaramboukas T. Duodenal leiomyoma: radiologic presentation of three cases. Eur J Radiol 1996; 22:126-8. [PMID: 8793431 DOI: 10.1016/0720-048x(95)00721-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- M Arvanitakis
- Department of Radiology, First General Hospital St. Paul, Thessaloniki, Greece
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15
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Abstract
The diagnosis of neoplasms of the small intestine remains a difficult challenge owing to their nonspecific clinical presentation. CT is an efficient and contributive tool in their diagnosis and preoperative staging. Enabled by CT, the evaluation of the intramural and extramural portions of such tumors complements the mucosal analysis allowed by barium examination. Strict technical rules should be applied to minimize pitfalls mainly resulting from insufficient bowel opacification. Although characteristic appearances are rare, typical CT findings may suggest a specific diagnosis where lipomas and carcinoid tumors are concerned.
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Affiliation(s)
- F Laurent
- Department of Radiology, Hôpital Haut Lévêque, CHU Bordeaux, France
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16
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NEOPLASMS OF THE UPPER GASTROINTESTINAL TRACT. Radiol Clin North Am 1994. [DOI: 10.1016/s0033-8389(22)00334-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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17
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Caruncho M, Pombo F, Arnal-Monreal F. Primary retroperitoneal serous cystadenocarcinoma of 'ovarian-type': US and CT findings. Eur J Radiol 1993; 17:115-6. [PMID: 8223678 DOI: 10.1016/0720-048x(93)90046-p] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- M Caruncho
- Department of Radiology, Hospital Juan Canalejo, La Coruña, Spain
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18
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Vinnicombe S, Grundy A. Case report: obstructive jaundice secondary to an intussuscepting duodenal villous adenoma. Clin Radiol 1992; 46:63-5. [PMID: 1643790 DOI: 10.1016/s0009-9260(05)80040-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Small intestinal tumours are rare, forming 1% of all gastrointestinal tumours; most occur in the duodenum. Villous adenomas form only a very small proportion of the duodenal tumours. They usually occur in the periampullary region and show a marked propensity for malignant change. The usual mode of presentation is with non-specific pain, jaundice or occult bleeding. Obstruction and pancreatitis are infrequent clinical presentations. Intussusception secondary to a duodenal tumour of any histological type is rarer still. A case of intussusception of a villous adenoma resulting in obstructive jaundice is described.
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Affiliation(s)
- S Vinnicombe
- Department of Diagnostic Radiology, St George's Hospital, London
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19
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Laurent F, Raynaud M, Biset JM, Boisserie-Lacroix M, Grelet P, Drouillard J. Diagnosis and categorization of small bowel neoplasms: role of computed tomography. GASTROINTESTINAL RADIOLOGY 1991; 16:115-9. [PMID: 2016021 DOI: 10.1007/bf01887323] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A retrospective study of 35 patients with small bowel neoplasms studied by computed tomography (CT) was performed. The tumor detection rate was 80%. Using the findings reported in the literature, an adequate histological diagnosis could be performed in 69% of the cases by CT. Lipomas, leiomyomas, leiomyosarcomas, and carcinoid tumors were well-recognized, but adenocarcinomas and lymphomas were often mistaken one for the other. An accurate preoperative staging was performed in 61% of the cases. CT failed to detect 75% of the invaded lymph nodes, 25% of the liver metastases, and 25% of the tumoral growth beyond the bowel wall. Despite major limitations in preoperative staging, a good detection rate and some features allowing a specific diagnosis advocate using CT along with the barium examination when clinical history suggests a small bowel tumor.
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Affiliation(s)
- F Laurent
- Department of Radiology, University Hospital of Bordeaux, Pessac, France
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20
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Vallance S. Duodenectomy without pancreatectomy for extensive benign villous adenoma of the duodenum. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1990; 60:311-4. [PMID: 2322220 DOI: 10.1111/j.1445-2197.1990.tb07374.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Villous adenomas of the duodenum are uncommon, but two have been treated recently in Blenheim. One of these was an extensive benign tumour involving most of the second part of the duodenum but causing no biliary tract obstruction. It was treated by pyloric sphincter-sparing duodenectomy without pancreatectomy, with repair by Roux loop to the bile and pancreatic ducts and proximal duodenum. This procedure does not appear to have been described previously.
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Affiliation(s)
- S Vallance
- Department of Surgery, Wairau Hospital, Blenheim, New Zealand
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21
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Finch PJ, Haddock J, Grundy A. Duodenal pseudotumour: a silent impacted common bile duct calculus. Postgrad Med J 1989; 65:794-6. [PMID: 2616411 PMCID: PMC2429839 DOI: 10.1136/pgmj.65.768.794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We report the case of a man with mild dyspeptic symptoms referred for barium meal, who was initially thought to have a duodenal tumour. Subsequent investigation showed this to be a pseudotumour caused by impaction of a gallstone in the distal common bile duct, and endoscopic sphincterotomy effected a cure. This readily treatable condition should be remembered when filling defects are demonstrated in the duodenal loop.
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Affiliation(s)
- P J Finch
- Department of Medicine, St George's Hospital, London, UK
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22
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CT of the Stomach and Duodenum. Radiol Clin North Am 1989. [DOI: 10.1016/s0033-8389(22)02154-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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