Tapering duodenoplasty and gastrojejunostomy in the management of idiopathic megaduodenum in children

Megaduodenum with Duodenal Diospyrobezoars

“… 6 8 A megaduodenum may be misdiagnosed and treated improperly owing to the lack of adequate knowledge and clinical experience. 7 In the present case, the patient had no anatomical abnormalities, except for a severely distended duodenal bulb, or passage disturbances of the UGI tract. Pathologic examination of the distal part of the distended duodenum could not be performed because the endoscope could not pass into the distal duodenum.…”

“… 4 5 Idiopathic megaduodenum, also known as congenital megaduodenum, is defined as a huge dilatation confined to the duodenum without mechanical obstruction. 6 Zhang et al 7 reported data on four patients with idiopathic megaduodenum. All four patients were children under the age of 12 years and had undergone operation for relieving symptoms of abdominal distension, nausea, vomiting, and malnutrition.…”

“…These patients had a massively dilated duodenum with a slightly thickened duodenal wall, but no obvious mechanical obstruction was observed on examination. 7 In rare cases, a megaduodenum can be secondary to visceral myopathy or neuropathy associated with polymyositis and may result from the absence of the parasympathetic ganglion cells in Auerbach's plexus. 6 8 A megaduodenum may be misdiagnosed and treated improperly owing to the lack of adequate knowledge and clinical experience.…”

Duodenal lengthening in an adult with ultra-short bowel syndrome. A case report

“…Megaduodenum facilitates pyloric incompetence with alkaline reflux and dysmotility with stasis of intraluminal contents which may result in bacterial overgrowth and malabsorption. The classical standard duodenal tapering technique reduces the luminal diameter of the dilated duodenum by removing its anti-pancreatic border longitudinally, usually with stapler devices (8). The main advantage of this new technique is that an additional intestinal absorptive surface is obtained without the need to discard any duodenal portion.…”

Laparoscopic operations for chronic duodenal obstruction in children

“…Для обследования больных с явлениями меха-нической ХДН используют ультразвуковое исследо-вание (УЗИ), рентгеноконтрастное исследование пассажа по желудочно-кишечному тракту, компью-терную томографию (КТ) органов брюшной поло-сти, фиброгастродуоденоскопию (ФГДС) [8,10,11,15,26].…”