The Duodenum and Small Bowel
E. George Elias in CRC Handbook of Surgical Oncology, 2020
Primary neoplasms of the small intestine, including the duodenum, are uncommon tumors that are encountered infrequently in clinical practice when compared to other GI malignancies. Small bowel tumors can be either benign or malignant, with 40% of these tumors being benign and 60% being malignant. Most of the cases of small bowel neoplasms, benign or malignant, are diagnosed after the patient has persistent symptoms. Sarcomas of the small bowel are frequently encountered in the ileum. The most common one is leiomyosarcoma. Neurosarcomas including neurofibrosarcomas and malignant schwanomas are very rare tumors in the bowel. Metastatic tumors can be encountered in the small bowel. This could be the result of peritoneal seeding, or hematogenous spread. The prognostic factors for tumors of the small bowel and duodenum depend mainly on whether these tumors are benign or malignant. The surgical management of malignant tumors can be categorized into three areas: potentially curative, emergency, and palliative.
Locally Advanced, Unresectable Gastric Cancer
Savio George Barreto, Shailesh V. Shrikhande in Dilemmas in Abdominal Surgery, 2020
Gastric cancer is associated with a poor prognosis with a reported overall five-year survival rate between 20–25% across all stages. Patients diagnosed with earlier stages of gastric cancer have a distinct survival advantage compared to those with more advanced-stage disease. In clinical practice, for investigations and treatment purpose, gastric cancer is divided into the following groups: Common symptoms associated with locally advanced gastric cancer include vomiting and nausea, bleeding, abdominal pain, lump in epigastric region, unexplained weight loss, loss of appetite, and early satiety. Surgical resection is the principal therapy for gastric cancer, as it offers the only potential for cure. Neoadjuvant chemotherapy has an established role in patients with locally advanced resectable disease and is considered as standard of care in most parts of the world. The patient presented in the Case Scenario had a locally advanced gastric cancer with duodenal and pancreatic head involvement.
The birth of modern surgery – from Lister to the 20th century
Harold Ellis, Sala Abdalla in A History of Surgery, 2018
The years from the 1860s to the outbreak of the Great War in 1914 saw an extraordinary burgeoning of surgery. By the beginning of the 20th century, gall bladder surgery was becoming a routine procedure. Undoubtedly, the Frank Thomas Paul–Johannes von Mikulicz operation represented a considerable advance in making colonic surgery safe. Paul had a career that was typical of the surgeons of his era, who commenced their work in pre-Listerian days and went on to experience the almost miraculous differences produced by antiseptic and aseptic methods. Berkeley Moynihan was created as Baron Moynihan of Leeds in 1929 when, until then, the only other surgeon to have been elevated to the peerage was Joseph Lister. Perforation of a gastric or duodenal ulcer into the peritoneal cavity gives rise to sudden severe symptoms and usually leads to fatal peritonitis unless the perforation is closed.
Primary Follicular Lymphoma of the Duodenum
Published in Baylor University Medical Center Proceedings, 2015
Robbie L. Graham, Mabel A. Mardones, John R. Krause
Follicular lymphoma, a common nodal lymphoma, is rare in the gastrointestinal tract. When seen in this location, duodenal involvement is frequent. Most patients have localized disease, and survival appears to be excellent even without treatment. Although the outcomes are improved, the morphologic, immunophenotypic, and genetic features remain similar to those of nodal follicular lymphomas. We describe a woman with de novo follicular lymphoma of the duodenum and discuss the features of this remarkably indolent variant of follicular lymphoma.
Traumatic Rupture of a Duodenal Diverticulum: Case Report and Review of the Literature
Published in Acta Chirurgica Belgica, 2015
B. Majerus, P. Mathonet, J.-P. Haxhe
Duodenal diverticula are relatively common and usually asymptomatic (95%). Their perforation is a rare but harmful event. Traumatic perforation is exceptional. We report the case of a patient with such a lesion following a blunt trauma secondary to a car accident, and review the literature. Clinical presentation is aspecific and diagnosis is based upon CT scan imaging. Surgery is the recommended treatment consisting of diverticulectomy with transverse duodenal closure of the duodenum associated with retroperitoneal drainage.
Adenocarcinoma of the Duodenum Arising in a Tubulo-Villous Adenoma
Published in Acta Chirurgica Belgica, 2009
A.-C. Lemyé, V. Guy-Viterbo, E. van Vyve
Villous adenoma of the duodenum is rare and has a high prevalence of cancer. We report here an unusual case of a 73-year-old man who presented with a tumour on the second part of the duodenum with moderate dysplasia of a tubulo-villous adenoma at the biopsies. A segmental duodeno-jejunal resection was performed and the resection margins were negative. The final histological analysis was a moderately differentiated invasive duodenal adenocarcinoma (pT3Nx). Management of these tumours is discussed here.
Related Knowledge Centers
- Duodenal Bulb
- Ileum
- Digestion
- Small Intestine
- Jejunum
- Stomach
- Ligament of Treitz