Acquired Constricting and Restricting Lesions of the Descending Duodenum

Carbó, Alberto; Sangster, Guillermo; Caraway, Jessica; Heldmann, Maureen; Thomas, Jaiyeola; Takalkar, Amol

doi:10.1148/rg.345130055

Cited by 10 publications

(6 citation statements)

References 32 publications

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“…The descending part of the duodenum is one of the most important segments of the digestive tract, because at this level the release of bile and pancreatic enzymes through the hepatopancreatic duct take place, which results from the union of the common bile duct with the pancreatic duct. Complete or partial obstruction of the duodenum interferes with the normal passage of the digestive content from the stomach, as well as with the drainage of the gallbladder, the intrahepatic bile ducts and the pancreatic enzymes, which can lead to severe complications (17).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Impact of retroperitoneal tumors on the digestive tract (Review)

Marcu¹,

Iorga²,

Diaconu

et al. 2022

Exp Ther Med

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Primary retroperitoneal tumors are a rare group of neoplasms that often prove to be a real therapeutic challenge. The clinical picture is in most cases nonspecific, being the result of nearby tissue and organ compression, displacement and/or invasion, and it usually includes a variety of deceiving signs and symptoms that may lead to diagnostic errors. During the course of the disease, up to half of the patients diagnosed with retroperitoneal tumors can develop gastrointestinal symptoms, the incidence of such symptoms significantly increasing with tumor size. Therefore, symptoms such as abdominal distension, diffuse abdominal pain or epigastric pain mimicking acute pancreatitis, diarrhea, constipation, jaundice, hematemesis, melena and hematochezia can be found. The mainstream treatment for primary retroperitoneal tumors is surgical excision, chemotherapy and radiotherapy but associated with poor results. Due to their rarity, as well as to the complexity of these tumors, patients should be managed in high volume centers that allow the possibility of a multidisciplinary approach.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Impact of retroperitoneal tumors on the digestive tract (Review)

Marcu¹,

Iorga²,

Diaconu

et al. 2022

Exp Ther Med

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“…13 ) [ 13 ], and the second is a fibrotic reaction due to compression by pseudocysts or by an enlarged pancreatic head. Pancreatic inflammatory fluid collections and pseudocysts develop in up to 50% of patients with acute pancreatitis [ 14 ]. CT shows displacement and extrinsic compression of the descending duodenum without mucosal abnormalities secondary to a well-defined fluid collection with low attenuation (<15 HU) surrounded by a peripheral fibrous capsule (Fig.…”

Section: Inflammatory (Peri)duodenal Processesmentioning

confidence: 99%

“…Isolated duodenal involvement in Crohn’s disease is rare, being found in roughly 0.5% to 4–5% of cases [ 1 , 3 ], although the duodenum is affected in 5% to 20% of patients with Crohn’s disease of the small bowel and colon [ 14 ]. The purpose of cross-sectional imaging is to determine the number, length, and location of intestinal lesions, to identify areas of stenosis and characterize them as inflammatory or fibrotic, and to identify complications such as fistulas or abscesses.…”

Section: Inflammatory (Peri)duodenal Processesmentioning

confidence: 99%

Imaging of non-neoplastic duodenal diseases. A pictorial review with emphasis on MDCT

et al. 2018

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A wide spectrum of abnormalities can affect the duodenum, ranging from congenital anomalies to traumatic and inflammatory entities. The location of the duodenum and its close relationship with other organs make it easy to miss or misinterpret duodenal abnormalities on cross-sectional imaging. Endoscopy has largely supplanted fluoroscopy for the assessment of the duodenal lumen. Cross-sectional imaging modalities, especially multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI), enable comprehensive assessment of the duodenum and surrounding viscera. Although overlapping imaging findings can make it difficult to differentiate between some lesions, characteristic features may suggest a specific diagnosis in some cases. Familiarity with pathologic conditions that can affect the duodenum and with the optimal MDCT and MRI techniques for studying them can help ensure diagnostic accuracy in duodenal diseases. The goal of this pictorial review is to illustrate the most common non-malignant duodenal processes. Special emphasis is placed on MDCT features and their endoscopic correlation as well as on avoiding the most common pitfalls in the evaluation of the duodenum.Teaching points • Cross-sectional imaging modalities enable comprehensive assessment of duodenum diseases. • Causes of duodenal obstruction include intraluminal masses, inflammation and hematomas. • Distinguishing between tumour and groove pancreatitis can be challenging by cross-sectional imaging. • Infectious diseases of the duodenum are difficult to diagnose, as the findings are not specific. • The most common cause of nonvariceal upper gastrointestinal bleeding is peptic ulcer disease.

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“…The common bile duct and the pancreatic duct open through the major papilla, which marks the beginning of this segment. The segment then courses just anterolateral to the inferior vena cava, posterior to the transverse colon, intimately in relation to the head of pancreas [1].…”

Section: Introductionmentioning

confidence: 99%

Distal Duodenal Obstruction: a Surgical Enigma

et al. 2017

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The postbulbar segment also known as the distal duodenum is a separate clinical entity in terms of the intrinsic pathologies of this region and its varied anatomical relations. The common bile duct and the pancreatic duct open through the major papilla, which marks the beginning of this segment. Distal duodenal obstruction can be defined as a clinicoradiological entity that is characterized by features of gastric outlet obstruction with recurrent bilious vomiting and a radiological evidence of postbulbar obstruction. A Medline search for distal duodenal obstruction revealed 1409 entries, mostly in the form of case reports. In the last 10 years, 310 cases are reported. Clinical features like abdominal pain, nausea, and vomiting are non-specific and quite similar to gastric outlet obstruction. Clinical findings are also non-specific and do not aid in diagnosis. Laboratory findings also do not add much. Contrast-enhanced CT scan and MR enterography are diagnostic modalities of choice. Distal duodenal obstruction is a clinical entity that has a wide list of differential diagnosis which requires due consideration in terms of its management and follow-up. Most of these lesions require adequate workup with the help of a multidisciplinary team consisting of radiologists, gastroenterologists, and pathologists to adequately diagnose and stage the disease before a treatment plan is formulated. A thorough knowledge is a must regarding the treatment options available for each of the conditions so that the management can be personalized leading to better results.

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Acquired Constricting and Restricting Lesions of the Descending Duodenum

Cited by 10 publications

References 32 publications

Impact of retroperitoneal tumors on the digestive tract (Review)

Impact of retroperitoneal tumors on the digestive tract (Review)

Imaging of non-neoplastic duodenal diseases. A pictorial review with emphasis on MDCT

Distal Duodenal Obstruction: a Surgical Enigma

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