1.Pyeloduodenal Fistula Successfully Treated By Endoscopic Ligation without Surgical Nephrectomy: Case Report.
Kyung Nam LEE ; In Hye HWANG ; Min Ji SHIN ; Soo Bong LEE ; Il Young KIM ; Dong Won LEE ; Harin RHEE ; Byeong Yun YANG ; Eun Young SEONG ; Ihm Soo KWAK
Journal of Korean Medical Science 2014;29(1):141-144
A 74-yr-old woman presented with fever and abdominal discomfort. She was in a septic condition caused by urinary tract infection. Her computed tomogram of the abdomen revealed features of hydronephrosis with ureteral stones in both kidneys. During percutaneous nephrostomies, right pyeloduodenal fistula (PDF) was diagnosed. Elective surgery was originally planned but the patient was in a poor condition to undergo surgery. Instead, 2 times endoscopic clipping and ligation by endoloop were applied with parenteral antibiotics for the fistula lesion. On admission day 30, she was discharged from the hospital after confirmation of no more contrast leakage on fistulography. We reviewed the literature and discuss the etiologies, clinical presentations, diagnosis, and treatment of PDF.
Aged
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Duodenal Diseases/complications/radiography/*surgery
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Female
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Humans
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Hydronephrosis/complications/radiography
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Intestinal Fistula/complications/radiography/*surgery
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Kidney/radiography/surgery
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Kidney Calculi/complications/radiography
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Kidney Diseases/complications/radiography/*surgery
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Ligation
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Urethral Obstruction/complications/radiography
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Urinary Fistula/complications/radiography/*surgery
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Urinary Tract Infections/complications/radiography
2.A Case of an Intraluminal Duodenal Diverticulum Managed with Endoscopic Incision and Ligation using Needle-knife and Detachable Snare.
Young Dae PARK ; Yun Jin CHUNG ; Seong Woo JEON ; Chang Min CHO ; Won Young TAK ; Young Oh KWEON ; Sung Kook KIM ; Yong Hwan CHOI
The Korean Journal of Gastroenterology 2007;49(3):177-182
An intraluminal duodenal diverticulum (IDD) is a rare congenital anomaly consisted of a sac-like mucosal projection within the second portion of the duodenum. Even though most of cases are asymptomatic, patients may develop recurrent abdominal pain, pancreatitis, and gastrointestinal bleeding. We report a case of symptomatic IDD which presented as acute pancreatitis and obscure gastrointestinal bleeding. Diagnosis was made by typical findings of upper GI series and coronal reformatted CT images. Although surgical resection is the treatment of choice, endoscopic incision and ligation with detachable snare was performed which led to a good result.
Acute Disease
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Adult
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Diverticulum/radiography/*surgery
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Duodenal Diseases/radiography/*surgery
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*Endoscopes, Gastrointestinal
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Endoscopy, Gastrointestinal
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Female
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Gastrointestinal Hemorrhage/diagnosis
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Humans
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Pancreatitis/diagnosis
3.Brunnera's Gland Hyperplasia: Treatment of Severe Diffuse Nodular Hyperplasia Mimicking a Malignancy on Pancreatic-Duodenal Area.
Woong Chul LEE ; Hyeon Woong YANG ; Yun Jung LEE ; Sung Hee JUNG ; Gi Young CHOI ; Hoon GO ; Anna KIM ; Sang Woo CHA
Journal of Korean Medical Science 2008;23(3):540-543
Brunnera's gland hyperplasia is a benign tumor of the duodenum and it is rarely associated with clinical symptoms. We report on a 64-yr-old man with Brunnera's gland hyperplasia who had undergone a duodenocephalo-pancreatectomy. The reason is that he presented upper gastrointestinal obstructive symptoms and the esophagogastroduodenoscopic finding revealed the lesion to be an infiltrating type mass on the second portion of the duodenum with luminal narrowing. An abdominal computed tomography showed a 2.5 cm-sized mass in the duodenal second portion with a suspicious pancreatic invasion and 7 mm-sized lymph node around the duodenum. Duodenocephalopancreatectomy was successfully performed. Histological examination revealed a Brunnera's gland hyperplasia. The final diagnosis was the coexistence of Brunnera's gland hyperplasia and pancreatic heterotopia with a pancreatic head invasion. The literature on Brunnera's gland hyperplasia is reviewed.
Brunner Glands/*pathology/radiography
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*Choristoma
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Diagnosis, Differential
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Duodenal Neoplasms/*pathology/radiography/surgery
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Duodenum/pathology/radiography
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Endoscopy, Gastrointestinal
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Humans
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Hyperplasia
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Male
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Middle Aged
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Pancreatic Diseases/*pathology/radiography
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Pancreaticoduodenectomy
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Severity of Illness Index
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Tomography, X-Ray Computed