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[en] We report a case of transarterial chemoembolization (TACE)-related acute ischemic duodenal ulcer that developed in association with dissection of the superior mesenteric artery. We conclude that the acute duodenal ulcer was developed by ischemia related to superior mesenteric artery dissection during TACE. TACE should be conducted carefully with continuous observation of abdominal arteries.
[en] This study was carried out to analyze the distribution of age, sex, chief complaint, physical examination and findings of chest x-ray films before operation in 59 cases of peptic ulcer perforation. The ratio of male to female was 1.7 : 1 and incidence of the ulcer perforation was most common in 5th decades. Thirty five among 59 cases showed pleural effusion, segmental atelectasis and pneumonic infiltration on chest x-ray film. Twenty nine among 50 cases of duodenal ulcer perforation and 6 of 9 cases of stomach ulcer perforation showed positive chest x-ray findings. No relationship was found between fever and preoperative chest x-ray findings
[en] Our report reviews the radiologic findings in 34 cases of duodenal malignant tumors with rare occurrence seen at Severance Hospital between the year 1965 through 1979. Histologic diagnosis is predominantly adenocarcinoma in cases of malignant tumors in the duodenum. Suprapapillary type showed polypoid mass with irregular mucosal ulcer in contrast to the annular constrictive lesions of infrapapillary. Irregular nodular filling defects or ulcer near the papillary area, associated with dialtation of gallbladder or common bite duct, were main characteristic radiologic features of periampullary carcinoma. Leiomyosarcoma showed more prominent exoenteric growth rather than intraluminal mass. But malignant lymphoma revealed relatively variable radiologic findings. The diffuse irregular mucosal thickening in the duodenum can be considered as radiologic manifestations of rare disease such as Extramedullary Plasmocytoma and Histiocytic Medullary Reticulosis.
[en] The UGI studies had been performed to 238 patients below the age of 15 years during the period from Jan. 1979 to Jul. 1983 in SCH hospital. The results are as follows: 1. Among 238 cases, 48 cases revealed peptic ulcers of stomach or duodenum (20.2%). The ulcer was in 31/37 cases of male patients (22.6%), and in 17/101 cases of female (16.8). Below the age of 5 years, ulcer was noted in 9 cases among 61 cases (14.8%), whereas above 5 years, in 39 cases among 177 patients (22.0%). 2. In the age group below 5 years, mostly the objective symptoms were discovered (8/9), but above 5 years, complained of subjective symptoms (30/39). 3. The predominant site of peptic ulcer was gastric antrum in the age group below 5 years (7/9), whereas duodenal bulb above 5 years (33/43). 4. Gastric antrum or duodenal bulb deformity was revealed in 13 cases and most of them were in the age group above 5 years. 5. All lesions of peptic ulcers in this study were benign in nature. 6. In follow up study after 1 or 2 months, ulcer was decreased in size strikingly (9/11)
[en] Aortic aneurysm has been reported to be the dominant cause of primary iliac-enteric fistula (IEF) in >70% of cases ; other less common causes of primary IEF include peptic ulcer, primary aortitis, pancreatic pseudocyst, or neoplastic erosion into an adjacent artery [2, 3]. We describe an unusual case of IEF managed with a staged approach using an endovascular stent-graft as a “bridge” in the emergency setting to optimize the next elective definitive excision of the lesion.
[en] Gingival adenoid cystic carcinoma (ACC) is a rare malignancy. We describe the diagnosis and treatment of a 43 year-old woman who presented with a persistent oral ulcer for approximately 1 year, and subsequent pain in the left posterior maxillary region. Clinical examination revealed an ulcer in the left upper molar gingiva, with swelling in the region from the second premolar to the third molar. X-ray images demonstrated the involvement of the maxillary alveolar bone. The histopathological and immunohistochemical features were diagnostic of ACC. ACC is often presented as a gingival lesion; thus, it may easily be neglected by patients. The identification of this tumor using specific pathological analyses prevents misdiagnosis and enables clinicians to determine the appropriate treatment. In this case, no recurrence or distant metastasis was observed after 2 years of follow-up
[en] We report two patients with ectopic gastric mucosa in the oesophagus in whom emergency contrast medium studies after traumatic endoscopy revealed broad, flat depressions on the right lateral wall of the upper oesophagus that could initially be mistaken for ulcers or even intramural dissections. However, the appearance and location of these lesions is so characteristic of ectopic gastric mucosa that confirmation with endoscopic biopsy specimens probably is not required in asymptomatic patients
[en] To evaluate the efficacy of ultrasonography in patients with equivocal (or uncertain) clinical findings of perforated duodenal ulcer. Ultrasonography of eight patients with clinically suspected perforated duodenal ulcer but no free gas shadow seen on simple abdomen film was prospectively evaluated and compared with the findings of fifty normal patients. The distance were measured between: 1) the left lobe of the liver and the duodenum (hepatoduodenal interface, HDI). 2) the posterior margin of the duodenum and the anterior margin of the pancreas (pancreaticoduodenal interface, PDI). The echo-pattern of each interface was also evaluated, and the relationship between echo-pattern and each interface or distance was analyzed in addition to the assessment of statistical significance. In the normal subjects (n=50), HDI and PDI echos were asymmetrical, homogeneously curvilinear echogenicity, and the average distance of HDI, PDI and HPD was 2.60 1.00 mm, 2.62 0.70 mm and 10.10 3.48 mm, respectively. However, in 8 patients with perforated duodenal ulcer, HDI PDI was seen as asymmetrically inhomogenous, thickened hyperechogenicity just like two crosstie under railroad, and the average distance of HDI, PDI and HPD was 9.38 3.28 mm, 7.38 2.03 mm and 24.12 4.35 mm. There was a statistically significant difference (p<0.0001) in HDI, PDI and HPD of two groups, the normal group and patient group with perforated duodenal ulcer. Ultrasonographic findings of patients with perforated duodenal ulcer include symmetrically inhomogenous, thickened hyperechogenicity in addition to the wider hepatopancreatic distance.
[en] Two cases of duodenal bezoars are presented. Both were within pseudodiverticula of the duodenal bulbs which were created by chronic active ulcer disease. It is felt that deformed duodenal bulb interfered with transit of the gastrointestinal content causing the formation of bezoar within pseudodiverticula.