Primary aorto-duodenal fistula is a rare and life-threatening cause of upper gastro-intestinal bleed. In this case report, a patient presented acutely with several episodes of haematochezia and pulseless lower limbs bilaterally. Primary aorto-duodenal fistula with peripheral vascular disease was diagnosed after an urgent CT angiogram was performed. She underwent left axillo-bifemoral bypass, resection of the fistula, Rouxen-Y gastro-jejunostomy, pyloric exclusion and controlled duodenal fistula the following day.
Aortic Diseases/*diagnosis ; Duodenal Diseases/*diagnosis ; Intestinal Fistula/*diagnosis

Background: The role of Helicobacter pylori live in digestive tract cause digestive disorder are confirmed. Objectives: To assess the relationship between seroprevalence of Helicobacter pylori (HP) in children and history of digestive disorders in children and their parents. Subjects and method: In this cross-sectional study, history of digestive disorders (recurrent epigastralgy at least 3 episodes in a duration at least 3 months, confirmed either by upper endoscopy or by gastric radiography with contrast or ameloration by treatment with anti - acid) was gathered using questionnaire with additional examination of individual health book, prescription or discharge certificate of a population of 818 children <15 years old in pediatric department, Bach Mai hospital and 369 children <18 in a rural commune. Seroprevalence was determined by ELISA with cut - off at 0.18 optic density. Results:Among in - patients, seroprevalence was 52.6% (20/38) in children with digestive history, significantly higher than 32.6% (254/780) in those who were without this history (p=0.013); risk for HP infection in children with the history was 4.8 higher than that in those who were without the history [OR (95% CI): 4.79 (1.62-9.16)), while the difference in HP seroprevalence was insignificant in children whose mother or father was with or without the history (p > 0.05). Among children in the community, the difference in HP seroprevalence of 72.7% (8/11) in children with and 55.0% (250/373) in those without the history was statistically insignificant (p>0.05). However, HP seroprevalence in children whose father or mother was with the history was of 71.8% (28/39) and 70.5% (31/44), respectivly, significantly higher than 43.1 % (94/318) and 45.6% (125/274) in those whose father or mother was without the history, respectively (p < 0.05). Risk for being HP seropositive in children whose father was with the history was 3.4 folds higher than those whose father was without the history [OR (95% CI): 3.36 (1.38-7.54)] and that in children whose mother was with the history was 2.9 folds higher than in those whose mother was without the history [OR (95% CI): 2.91 (1.41-5.26)]. Conclusion: It exsisted a discrepancy in relationship between HP seroprevalence in children and history of digestive disorders in 2 groups of population in the hospital and in the community, and further studies with larger size were warranted to better clarify this relationship.
Helicobacter pylori/ pathogenicity ; Stomach/ pathology ; Duodenal Diseases/ diagnosis ; pathology ; Child

Background: Injuries to the pancreaticoduodenal complex present a significant challenge both in diagnosis and management. The retroperitoneal location of the pancreas means that it is not a common site of injury, but this also contributes to the difficulty in diagnosis. Objective: To evaluate changes of serum amylase level before the operation of pancreaticoduodenal injuries. Subjects and method: Prospective analysis of 156 patients with pancreaticoduodenal injuries from January 2000 to December 2006 was measured serum amylase level at admission. The factors analyzed in the study included age, gender, time elapsed from injury to admission, type of pancreaticoduodenal injuries according to The American Association for the Surgery of Trauma 1990. Results: The serum amylase level was found to be abnormal in all patients admitted more than 3 hours after trauma. Various comparisons between patients with elevated (78.2%) and nonelevated (26.3%) serum amylase levels showed the statistical significance solely of the time elapsed from injury to admission. The major factor that influenced the serum amylase level on admission appeared to be the time elapsed from injury to admission. Determination of the serum amylase level was no diagnosis within 3 hours or less after trauma, irrespective of the type of injury. Conclusions: To avoid failure in the detection of pancreaticoduodenal injuries, the authors advocate determination of serum amylase levels more than 3 hours after trauma.
Amylases/ diagnostic use ; Duodenal Diseases/ diagnosis ; Pancreatic Ducts/ injuries

Ectopic pancreas is no longer a rare clinical condition, but its unusual clinical manifestations, locations or complications are of clinical interest. We experienced a case (a 48 year-old male patient) of duodenal ectopic pancreas complicated by chronic pancreatitis and pseudocyst formation of which preoperative imaging findings mimicked a large duodenal submucosal tumor with cystic degeneration such as a leiomyosarcoma. Simultaneous chronic pancreatitis was also demonstrated in the isotopic pancreas of the patient postoperatively. Herein we report a rare clinical condition occurring in an ectopic pancreas with a brief review of the literature.
Case Report ; Choristoma/complications/*diagnosis ; Chronic Disease ; Diagnosis, Differential ; Duodenal Diseases/complications/*diagnosis ; Duodenal Neoplasms/diagnosis ; Human ; Male ; Middle Age ; *Pancreas ; Pancreatic Pseudocyst/complications/*diagnosis ; Pancreatitis/complications/*diagnosis

Brunner's gland hamartomas are rare tumors of duodenum, they are often discovered incidentally during esophagogastroduodenoscopy or upper gastrointestinal series. These tumors arise mainly in the duodenal bulb and can present with gastrointestinal hemorrhage and intestinal obstruction. Most of Brunner's gland hamartomas are located within the range of the standard esophagogastroduodenoscope. However, they are rarely located below the third portion of duodenum. As well known, the small intestine, including the 4th portion of duodenum, jejunum, and ileum, is relatively inaccessible with routine endoscopy. Thus, the diagnosis of Brunner's gland hamartoma in these area can be delayed up to several months after onset of symptoms. We report a case of Brunner's gland hamartoma which was located in the fourth portion of the duodenum and presented as obscure gastrointestinal hemorrhage. Radiologic, surgical, and pathologic appearances are presented.
Brunner Glands ; Duodenal Diseases/*complications/diagnosis ; Female ; Gastrointestinal Hemorrhage/*etiology ; Hamartoma/*complications/diagnosis ; Humans ; Middle Aged

Animals ; Duodenal Diseases ; diagnosis ; Duodenum ; parasitology ; pathology ; Humans ; Intestinal Perforation ; diagnosis ; Male ; Taenia saginata ; pathogenicity

No abstract availble.
Abdominal Pain/*diagnosis ; Aged ; Animals ; Ascariasis/*diagnosis/parasitology ; *Ascaris lumbricoides ; Duodenal Diseases/*diagnosis/*parasitology ; Duodenoscopy ; Female ; Humans

A systematic and effective welfare system for people with digestive system impairments is required. In Korea, an objective and scientific rating guideline does not exist to judge the digestive system impairments. Whether the impairments exist or not and the degree of it need to be examined. Thus, with these considerations we need a scientific rating guideline for digestive system impairments to fit our cultural and social background. In 2007, a research team, for the development of rating impairment guidelines, was organized under the supervision of Korean Academy of Medical Sciences. The rating guidelines for digestive system impairments was classified into upper and lower gastrointestinal tracts impairments and liver impairment. We developed objective rating guidelines for the upper gastrointestinal tract, the impairment generated after surgery for the stomach, duodenum, esophagus, and for the lower gastrointestinal tract, the impairment generated after construction and surgery for colon, rectum, anus, and intestinal stomas. We tried to make the rating impairment guidelines to include science, objectivity, convenience, rationality, and actuality. We especially emphasized objectivity as the most important value. We worked to make it easy and convenient to use for both the subjects who received the impairment ratings and the doctors who will give the ratings.
Digestive System Diseases/classification/*diagnosis ; *Disability Evaluation ; Duodenal Diseases/classification/diagnosis ; Esophageal Diseases/classification/diagnosis ; Humans ; Inflammatory Bowel Diseases/classification/diagnosis ; Korea ; Liver Diseases/classification/diagnosis ; Postoperative Complications/classification/diagnosis ; Program Development ; Severity of Illness Index ; Stomach Diseases/classification/diagnosis

Hepatocellular carcinoma (HCC) is one of the most common malignant neoplasms occuring worldwide. Surgical resection currently provides the best chance of long-term tumor free survival, but the most HCCs are not candidates for surgical excision due to poor liver function or poor medical background. Numerous noninvasive alternatives to surgical resection have been introduced to treat liver cancers. Radiofrequency thermal ablation has begun to receive much attention as an effective and minimally invasive technique for the local control of HCC. The biliary system related complications after radiofrequency ablation has rarely been reported. We report a case of biliary-duodenal fistula with liver abscess after radiofrequency ablation for HCC. The case was treated by abscess drainage and antibiotics.
Biliary Fistula/*diagnosis/etiology ; Carcinoma, Hepatocellular/diagnosis/*surgery ; Catheter Ablation/*adverse effects ; Duodenal Diseases/*diagnosis/etiology ; Duodenal Obstruction/diagnosis ; Female ; Humans ; Intestinal Fistula/*diagnosis/etiology ; Liver Neoplasms/diagnosis/*surgery ; Middle Aged ; Tomography, X-Ray Computed

A duodenal duplication cyst is an uncommon congenital anomaly that is usually encountered during infancy or in early childhood. Duodenal duplication cysts generally appear on the first or second portion of the duodenum and may cause duodenal obstruction, hemorrhage or pancreatitis. Here, we report a case of a duodenal duplication cyst on the second and third portion of the duodenum in an old aged man with obstructive jaundice and acute pancreatitis, which was treated successfully by a surgical excision.
Abnormalities ; Aged ; *Cysts/complications/diagnosis/pathology ; *Duodenal Diseases/complications/diagnosis/pathology ; Humans ; Jaundice, Obstructive/*etiology ; Male ; Pancreatitis/*etiology