Dieulafoy Lesion in a Congenital Double Pylorus

Wetscher, Gerold J.; Schwab, G.; Glaser, Kevin J.; Fend, F.; Bodner, E; Pointner, Rudolph

doi:10.1055/s-2007-1009003

Cited by 7 publications

(9 citation statements)

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“…We identified five other patients with congenital double pylorus (Table 1) (3,4,(6)(7)(8). None had evidence of ulcer disease.…”

Section: Discussionmentioning

confidence: 99%

“…In two cases, the accessory channel of the double pylorus lay along the lesser curvature, and in three cases it lay along the greater curvature. In one case the localization was not clear (3). An associated congenital abnormality was found in three cases: heterotopic benign pancreatic tissue in the adjacent anterior wall of the stomach (7); an aberrant pancreatic duct emptying in the wall of the gastric antrum, malrotation of the gut in a child with Pierre-Robin complex (4); and a Dieulafoy lesion (3).…”

Section: Discussionmentioning

confidence: 99%

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A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

Wolters

Nikkels²,

Zee³

et al. 2001

Journal of Pediatric Gastroenterology and Nutrition

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Double pylorus is a rare condition consisting of a double communication between the gastric antrum and the duodenal bulb. Double pylorus can occur as a congenital abnormality or as a complication of peptic ulcer disease. Although almost 100 patients with acquired double pylorus have been described (1,2), only a few patients with congenital double pylorus have been described, and, in only one patient, this anomaly was recognized in childhood (3). Herein we describe another child with congenital double pylorus, who presented with gastric outlet obstruction. CASE REPORTThe patient, a 5.5-year-old boy, was referred to us because of poor weight gain and a history of vomiting and epigastric pain since the age of 4 years. Epigastric pain occurred during the day and in the evening and was worse after eating. In the late evening, the patient usually vomited part of his previous meal. His appetite was below normal because of a constant feeling of fullness. At physical examination the child was determined to be well developed. However, height and weight, which had been 1 SD below the mean during the first few years of life, were now more than 2 SDs below the mean. The abdomen was distended without enlarged organs. Bowel sounds were normal. Findings on contrast imaging studies of the esophagus, stomach, and proximal small bowel were initially reported as normal.At endoscopy, two slitlike openings were observed at the pylorus (Fig. 1). The openings failed to dilate during examination and an Olympus XP-240 (Olympus, Tokyo, Japan) endoscope (outer diameter, 7 mm) could not be passed through either opening. The mucosae of the stomach and the esophagus were normal. Because of these findings, the contrast imaging study was repeated with special attention to the pyloric area. During this subsequent examination (Fig. 2) two barium-filled channels were seen, one cephalad to the other. Only a minimal amount of barium entered the caudally located channel on the greater curvature side. This channel ended blindly in a cystlike structure. This cystlike structure had an extrinsic mass effect on the true channel, so only a minimal amount of barium could pass into the duodenum. Subsequent pyloric ultrasonography showed a region of low echo density near the proximal duodenum.At surgery, duplication of the pyloric channel was found. The caudally located channel, on the greater curvature side of the stomach, ended blindly. A cystlike structure was found in the wall of this channel. When the duodenum was opened along its convex aspect, the cystlike structure bulged into and partly obstructed the lumen of the true pyloric channel. Truncal vagotomy, antrectomy, and gastroduodenostomy (Billroth 1) were performed. The surgical specimen consisted of the gastric antrum resected in continuity with a centimeter of duodenal cuff. After surgery, the patient was able to eat well without epigastric pain and without bouts of vomiting. In addition, after a 1-year follow-up, height and weight had returned to −1 SD.Dissection of the surgical specimen showed a d...

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“…We identified five other patients with congenital double pylorus (Table 1) (3,4,(6)(7)(8). None had evidence of ulcer disease.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

Wolters

Nikkels²,

Zee³

et al. 2001

Journal of Pediatric Gastroenterology and Nutrition

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show abstract

“…Two slitlike openings are seen at the end of the antrum; in most cases, both communicate with the duodenal bulb. Almost 100 patients with this anomaly have been described (1–3). All but one of these patients described were adults (4).…”

Section: Discussionmentioning

confidence: 99%

“…Double pylorus can occur as a congenital abnormality or as a complication of peptic ulcer disease. Although almost 100 patients with acquired double pylorus have been described (1,2), only a few patients with congenital double pylorus have been described, and, in only one patient, this anomaly was recognized in childhood (3). Herein we describe another child with congenital double pylorus, who presented with gastric outlet obstruction.…”

mentioning

confidence: 99%

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

Wolters,

Nikkels,

Van Der Zee

et al. 2001

J. pediatr. gastroenterol. nutr.

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“…Für das Kolon wurde die Exulceratio simplex Dieulafoy erstmals 1985 von Barbier et al [26] beschrieben. Mittlerweile finden sich in der Literatur Fallbeschreibungen im Ösophagus [20,40], im Duodenum [21,36,39,43], im Dünndarm [22,23], in der Gallenblase [38] sowie im Kolon, Rektum (Tab. 1) und Anus [25].…”

Section: Introductionunclassified

Ulcus Dieulafoy des Colon ascendens

Vogel

Thomschke²,

Stolte³

2006

Z Gastroenterol

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Dieulafoy's lesion was described in 1896 by the French pathologist Georges D. Dieulafoy as a vascular malformation in the stomach. Although usually found in the stomach, the lesion may occur anywhere within the gastrointestinal tract and can cause severe hemorrhage. There is no sex or age predilection. The diagnosis is established endoscopically, and the current therapy of choice is endoscopic hemoclipping. Only rarely is the diagnosis confirmed histologically. We report the case of an elderly female patient who, while hospitalised for a slipped intervertebral disc, presented with lower gastrointestinal bleeding. The source of the bleeding was suspected to be in the right colon by endoscopy. Renewed massive bleeding necessitated surgical treatment with resection of the right hemicolon. The histological work-up of the resected specimen identified a 350-micron large tortuous submucosal artery that had eroded.

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Dieulafoy Lesion in a Congenital Double Pylorus

Cited by 7 publications

References 0 publications

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

Ulcus Dieulafoy des Colon ascendens

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