Duodenocolic fistula (DCF) is a rare complication of colon cancer with only 70 cases reported since its first description in 1862. Owing to its rarity, current knowledge on DCF still relies on single case reports. We present 2 cases of DCF from a hepatic flexure adenocarcinoma demonstrated initially by endoscopy. 2 adult male patients were admitted due to a 2-3-month history of right-upper quadrant pain, vomiting, diarrhoea and a palpable right upper quadrant mass. In both cases, a circumferential, friable mass was noted on upper endoscopy at the second portion of the duodenum, leading to the ascending colon. A similar-looking lesion was also noted on colonoscopy. Biopsies in both cases confirmed colonic adenocarcinoma. Owing to the advanced nature of the disease, en bloc resection was not achieved. Instead, tube jejunostomy and loop ileostomy were created. Both patients were discharged tolerating feeding with improvement in symptoms.
Management of mechanical damage is an issue that many pipeline operators are facing. This paper presents a method to characterize dents based on the analysis of the BJ Vectra Magnetic Flux Leakage (MFL) tool signals. This is an approach that predicts the severity of mechanical damage by identifying the presence of some key elements such as gouging, cracking, and metal loss within dents as well as multiple dents and wrinkles. Enbridge Pipelines Inc. worked with BJ Services to enhance the knowledge that can be gained from MFL tool signals by defining tool signal subtleties in dents. This additional characterization provides information about the existence of gouging, metal loss, and cracking. This has been accomplished through detailed studies of the ILI data and follow-up field investigations, which validate the predictions. One of the key learnings has been that the radial and circumferential components of the MFL Vectra tool are highly important in the characterization and classification of mechanical damage. Non-destructive examination has verified that predictions in detecting the presence of gouging and cracking (and other defects within dents based on tool signals) have been accurate.
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