21:19,21,Aug,2006 | (2331/0/0) | Original
Note: The trackback url will expire after 23:59:59 today
Note: The trackback url will expire after 23:59:59 today
JPD on the diagnosis and treatment of ERCP
Misdiagnosis of JPD analysis and removal techniques
JPD analysis of 68 cases
JPD syndrome Clinical analysis of 28 cases
Endoscopic papillary balloon dilatation treatment of duodenal diverticulum tube and biliary stones
Duodenal Diverticulum with 2 cases of obstructive jaundice
Diagnosis and treatment of duodenal diverticulum
Duodenal diverticulum resection in biliary tract surgery (1)
JPD syndrome diagnostic value of imaging
A case of descending part occupying
Duodenal Diverticulum and the relationship between bile duct stones and endoscopic treatment
Clinical analysis of 25 cases of duodenal injury
Duodenoscope EST lithotomy cholelithiasis Clinical analysis of 56 patients
Duodenal injury after surgical selection and Comparative Analysis
Narrowing of the duodenal papillitis clinical observation of 100 cases
Traumatic duodenal injury analysis of 16 cases
Improved retention of duodenal total resection of pancreatic head
Duodenal Diverticulum with 2 cases of obstructive jaundice
Duodenal papilla cancer diagnosis and treatment
Duodenal papilla cancer diagnosis and treatment
Wu Jiang, Chang-Sheng Deng, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
Project Leader: Wujiang, 430071, Wuchang District, Wuhan City, Hubei Province, 169 East Lake Road, Wuhan University Zhongnan Hospital of Internal Medicine. Nofirstname.lastname@example.org
Phone :027 -87,877,459
Received date :2003-03-08 Accepted :2003-04-05
Objective: To investigate the clinical manifestations of duodenal diverticulum, diagnosis, and treatment characteristics.
Methods: Near 20 a Wuhan University Zhongnan Hospital patients by X-ray barium meal, duodenal endoscopy and surgery of 120 cases found in patients with duodenal diverticula, were retrospectively reviewed.
Results: no special clinical features, and more confirmed by the X-ray examination, the majority of medical treatment.
Conclusion: Duodenal diverticulum no specific clinical features, diagnosis mainly relies on X-gastrointestinal barium meal and the stomach, duodenum, endoscopy identified. Asymptomatic no special treatment. Patients have gastrointestinal symptoms, and diverticula and other diseases coexist, should first consider the treatment of other diseases.
Wu Jiang, Chang-Sheng Deng. Duodenal diverticulum in 120 patients. World Journal of Gastroenterology 2003; 11 (11) :1824-1825
0 Introduction duodenal diverticulum is due to different causes local pathological duodenal bulging pouch-like. This collection of Wuhan University Zhongnan Hospital 1983-01/2002-12 hospitalized patients after gastrointestinal barium meal X- duodenal endoscopy and surgery duodenal diverticulum
1 Materials and methods
1.1 The material in this group of 120 patients, male 65 cases, female 55 cases. Aged 18-86 years, of which less than 1 case of 20-year-old ,20-29 ,30-39 years in 8 cases of 10 cases 13 cases 40-49 50-60-59 years 69 years 30 cases 34 cases 19 cases ,70-79 years, greater than or equal to 80 years in 5 cases. descending diverticulum in 91 cases, 7 cases the level of the Ministry or the Ministry of 9 patients with descending l Department of 5 cases, descending and empty, ileum in 2 cases, descending 1 patient with esophageal, bulb diverticulum in 5 cases. diverticulum number ranging from 1-4, a single in 105 cases. sizes, 4 Ã— greatest 5cm, smallest grain size only.
1.2 Methods and Statistics in patients with duodenal diverticula and treatment of clinical manifestations and outcome of the situation.
2.1 Clinical manifestations of 120 cases, 69 cases with digestive tract of other diseases: cholangitis, cholecystitis, cholelithiasis, 12 cases of acute pancreatitis in 3 cases, 10 cases of chronic gastritis, acute gastric mucosal lesion in 4 cases, duodenal inflammation , bulbar ulcer in 16 cases, 12 cases of hepatitis and fatty liver, liver cyst in 4 cases, esophagitis, intestinal heterotopic pancreas, liver cavernous lymphangioma, liver schistosomiasis, intestinal obstruction, jejunal leiomyosarcoma, colon polyps, ascending colon in 1. only 6 cases diagnosed as duodenal diverticulum admission. Its main symptoms are abdominal pain, digestive / discomfort (72.73%), nausea and vomiting (40.91%), vomiting blood and (or) melena (34.91%) and jaundice (6.82%). There were 16 cases of diverticulitis. The group, 50 patients with other systems associated with disease: 24 cases of cardiovascular system, respiratory system in 11 cases, 7 cases of urinary system, endocrine system, 5 cases (all diabetes), the nervous system in 3 cases.
2.2 Treatment and prognosis of this group, 10 patients underwent surgery: gastrectomy in 8 cases, 2 cases of duodenal diverticulum embedded operation. I are medical therapy, 1 patient died due to congestive cardiomyopathy.
3 Discussion diverticulum is a tubular organ originated in the pocket and the cystic structure. "Authenticity" diverticulum containing layers of the intestinal wall, "false" diverticulum is leaving the muscularis mucosa and submucosa defects outstanding due to  . duodenal diverticulum in a variety of upper gastrointestinal examination in the detection rate of about 2.50% . The middle-aged patients were more common (greater than or equal to 40 years 101 patients, 84.16%). male and female incidence were similar, male slightly higher (65/120, 54.17%), but some scholars  that women more common.
Duodenal diverticula occur in the descending part , and more in the descending medial from the ampulla Vater range of about 2.50cm . This group also down are more than the Ministry (91/120, 75.83%) Another 7 cases the level of the Ministry or the Ministry of 9 cases; bulb diverticulum in 5 cases there were associated with duodenal ulcer, the duodenal diverticulum may be caused by scar contraction of "pseudo" diverticulum. duodenal diverticulum in this group are mostly single (105/120, 87.50%), large and small, greatest 4 Ã— 5cm, smallest grain size only.
Most patients with this disease without clinical symptoms and signs can be . This group is not associated with other digestive diseases in 51 cases, including 10 cases manifested as abdominal pain / discomfort, nausea, vomiting, vomiting blood and (or) black stools, I have no gastrointestinal symptoms. The group, admission diagnosis was only 6 cases of duodenal diverticulum, duodenal diverticulum shows no specific clinical features.
The group had 16 cases of diverticulitis, and peptic ulcer in similar clinical manifestations: upper abdominal pain, nausea, belching, acid reflux and bloating. There are 12 cases with biliary disease, 3 patients with acute pancreatitis, possibly due to pressure diverticulum common bile duct and pancreatic duct or papillary edema, causing bile duct obstruction, biliary and pancreatic symptoms appear.
The diagnosis of duodenal diverticulum gastrointestinal barium meal X-reliance and stomach, duodenum, endoscopy identified, can also be found in surgery. Most of this group confirmed by the X-ray examination (103/120, 85.83% ), X-ray showed extraluminal duodenal diverticulum is protruding, round or oval-shaped pouch pocket shadow, outline clearly visible stretching diverticulum duodenal mucosa. If the common bile duct and pancreatic duct openings in the diverticulum , endoscopy and retrograde cholangiopancreatography help to determine the relationship between its anatomy. In addition, CT of duodenal diverticulum causing complications such as acute pancreatitis, which are certain diagnostic value .
If asymptomatic duodenal diverticulum without special treatment. If gastrointestinal symptoms in patients, and coexistence of other diseases, treatment of other diseases should be considered first. Medical treatment to take a more integrated approach: The acid antispasmodic drugs, prokinetic drugs and antibiotics. no improvement after medical treatment or have symptoms of complications, surgery may be considered (in this group, only 10 cases), indications for the diverticulum perforation, bleeding, a recreation room cancer, fistula, bowel obstruction, bile induced by repeated pancreatic complications and recurrent diverticulitis or diverticular bleeding, the medical treatment ineffective . surgical resection of a diverticulum, duodenal exclusion surgery, duodenal anastomosis .
Duodenal diverticulum prognosis is usually good, even if the occurrence of complications, if handled properly, can have a better prognosis.
4 References 1 Chang-Sheng Deng. Duodenal diverticulum. 1st edition. Beijing: People's Medical Publishing House, 2002; 172-173
2 Yin WY, Chen HT, Huang SM, Lin HH, Chang TM. Clinical analysis andliterature review of massive duodenal diverticular
bleeding. World J Surg 2001; 25:848-855
3 Gulotta G, Agosta G, Romano G. Perforated duodenal diverticulum: report of a case. Chir Ital 2001; 53:255-258
4 Mehrotra P, Chandra M, Mitra MK, Misra R. Massive bleeding fromduodenal diverticulum. Indian J Gastroenterol
5 De Rai P, Castoldi L, Tiberio G. Intraluminal duodenal diverticulumcausing acute pancreatitis: CT scan diagnosis and
review of the literature. Dig Surg 2000; 17:288-292
6 Shu-Dong Xiao. Jiangshao Ji Gastroenterology. 1st edition. Shanghai: Shanghai Science and Technology Press ,2001:839-841
Similar documentsã€‘ ã€China Academic Journal ago 10 1 Wang Xuhao; Sun Cheng Yi; what your province;; difficult endoscopic Sphincterotomy treatment experience of 165 cases of common bile duct stones [J]; Guizhou Medicine; 2010 03 2 Chen Hu; Wengxian Fu;; multiple duodenal diverticula case [J]; Journal of Digestive Endoscopy; 2006 03 3Alnusair MM; De Magalhaes-Silverman M.; Silverman WB; into a rainbow;; ERCP in the diagnosis of hematopoietic stem cell transplantation bile duct lesions of pancreatic function [J]; the World Core Medical Journals Abstracts (Gastroenterology Volume); 2006 09 4 Cao Zhao; spiral CT scan of obstructive jaundice in the clinical application of [J]; Modern Medicine; Zhao, 2005 01 5 North; duodenal injury diagnosis and treatment (report of 19 cases) [J]; Hainan Medical; 2005 01 6 YANG Ming, Xueying Wei, Guo Haiying; after total gastrectomy for gastric cancer and the Lahey method Lawrence Law Comparative digestive tract reconstruction [J]; Chinese Journal of General Surgery; 2005 01 7 Yin Yuling; 136 patients with blunt abdominal trauma diagnosis and treatment [J]; Rural Medicine; HD 2005 01 8 Ze, Lv Yingqian , Xiaodong, Hou Guangchang, Liuguang Mao, Li Huchen; 62 patients with pancreatic cancer [J]; Modern Journal of Integrated Traditional and Western; 2005 01 9 Fang; Surgery Causes of poor gastric tube [J]; modern Integrative Medicine magazines; 2005 01 10 Zhengsong Bo, Bao Zhi-Jun, Xiang Ping, Wang Gensheng; esomeprazole, clarithromycin and amoxicillin triple therapy for eradication of Helicobacter pylori short [J]; Chinese Journal of Clinical Medicine; 2005, 01 full-text database of China's important conference papers before 10 1 Hong Yan; Feng Li; Crisis Awareness in Millennium;; diarrhea caused by rotavirus [A]; China Institute of Veterinary Animal Husbandry and Veterinary Biotechnology credits Veterinary Conference and the Chinese Society for Immunology Immunization Branch of the Sixth Symposium Proceedings [C]; 2005 2 Zhu Bin;; imaging diagnosis of chronic pancreatitis [A]; 2005 National Academic Conference of chronic pancreatitis album [C]; 2005 3, Yu-Pei Zhao;; Surgical treatment of chronic pancreatitis [A]; 2005 National Academic Conference of chronic pancreatitis album [C]; 2005 4 Kou Yi; Yan-Qing Li; Mengmin; Ms Grace Fu; Shi Hwan; Futing Liang; Yanming Xian;; chronic biliary pancreatic Preliminary study on animal model of inflammation [A]; 2005 National Academic Conference of chronic pancreatitis album [C]; 2005 years 5 Zhaochun Gang; cattle Ya-ling;; CT diagnosis of gallbladder cancer [A]; First International Medical Imaging cum involved in compilation of medical academic conference papers [C]; 2005 6 Wang Xuemei;; big ultrasound diagnosis of retinopathy [A]; celebrate the Engineering Society of Ultrasound in Medicine 20th anniversary - of the Eighth National Conference Papers compilation of Ultrasound in Medicine [ C]; 2004 7 Lu Hongwei;; emergency bile leakage after biliary tract surgery causes and treatment of [A]; 2004 National Critical Care Medicine Conference Proceedings [C]; 2004 8 Jiangli Yun;; 308 cases of patients with digestive system Tongue analysis [A]; 2004 National Critical Care Medicine Conference Proceedings [C]; 2004 9 Han; Zhang Yuan; Zhao Qi; Headlines; Teng derivable;; small intestine histology nervous system development Research [A]; China Animal Husbandry and Veterinary Institute Academic Year and the 2004 Fifth National Conference on Animal Husbandry and Veterinary young scientists Proceedings (Volume) [C]; 2004 years 10 Tang flowers; Liu Huazhen; Peng Kemei; Chen Hua; ; different energy levels of the digestive tract morphology of Cherry Valley [A]; China Animal Husbandry and Veterinary Medicine Academic Society Annual Conference 2004, the Fifth National Conference on Animal Husbandry and Veterinary young scientists Proceedings (Volume) [C]; major newspapers in China in 2004 before the full-text database 10 1 Weiji Zhen; Gastroenterology true form after a meal [N]; health Times; 2005 2 Yuhua; broiler intestinal drug prevention and treatment of SARS [N]; China Animal Husbandry and Veterinary Report; 3 special correspondent in 2005 the yellow over red rock country; the world's most advanced endoscopic equipment "settle down" of the PLA General Hospital [N]; Popular Science reported; Tang Xiao 4, 2005; Children must gallstone surgery? [N]; public health reporting; 2005 5 Haoshu Jie; weaned piglet feed should acidification [N]; Heze Daily; 2005 6 correspondent in Wei reporter Zheng Lihui Luo Jian Mei; concerned about survival time quality of life [N]; Hangzhou Daily; 2005 Year 7 Science reporter Liu Ming Jiang Ning Xia Hongqing Zhao Fengyun; missile commander of the light of life [N]; Liberation Army Daily; 2005 8 Zhuang Qingping; bile reflux drug therapy [N]; Health News; Wuhan Union 9, 2005 Professor Jin Bi Hospital; as soon as possible within the blood vessel, "flows guilty": thrombosis [N]; family doctor reported; 10, 2005, Beijing chief physician Yu Guangming; silent myocardial ischemia must also attach importance to [N]; family doctor reported; PhD thesis, 2005, China's top 10 full-text database, 1 Lijun Bo; pig indica rice in aging mechanism of nutrient use [D]; China Agricultural University; 2005 2 Yang Weiren; rumen-protected amino acid digestion and metabolism of beef cattle and appropriate supply of [D]; China Agricultural University; 3, 2004, Li Jing; 37 â„ƒ constant heat stress on broiler acid-base balance of blood flow dynamics and the impact of [D]; China Agricultural University; 2004 4 Liu Yufeng; different drugs force characteristics and pathogenicity of IBDV strains Comparison of immunity [D]; China Agricultural University; 5 Su Pengcheng, 2004; different levels of dietary glucose metabolism in white cashmere goats under the conditions of the protein (amino acids) Distribution of [ D]; Inner Mongolia Agricultural University; Shu 2004 6 sources; casomorphin Identification and function of the digestive tract of piglets of [D]; Nanjing Agricultural University; 7, GUO Tong 2004; containing copper silicate nanoparticles on weaning piglet intestinal bacteria adsorption, sterilization mechanism of [D]; Zhejiang University; 8, 2004, Xu Xiaodong; familial adenomatous polyposis and the diagnosis and treatment of COX-2 gene expression [D]; Second Military Medical University; 9, 2004 Yu Bing; AMPK on lipid metabolism in pigs under stress regulation of [D]; Sichuan Agricultural University; 10 in 2003 and then Hong; Refreshing fiery law mechanism of resistance to chemotherapy and vomiting [D]; Beijing University of Chinese Medicine; China in 2003 Master database before the full paper 10 1 Qin Hai Jin; reflux Ning Tang on the role of reflux esophagitis and its mechanism of [D]; College of Traditional Chinese; 2, 2005, Zhou Jianjun; ducks, geese, emus auxin precursors cDNA cloning, localization, tissue expression and molecular evolution of [D]; China Agricultural University; 3, 2004, State Secretary for profit; different doses of cysteamine on sheep digestion and metabolism and production performance of [D]; China Agricultural University; 2004 4 Luo Ya