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Liu H, Chen K, Wang T, Ruan X, Wei J, Tang J, Li L, Qin J. Emerging trends and cross-country health inequalities in congenital birth defects: insights from the GBD 2021 study. Int J Equity Health 2025; 24:50. [PMID: 39979921 PMCID: PMC11844150 DOI: 10.1186/s12939-025-02412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Accepted: 02/10/2025] [Indexed: 02/22/2025] Open
Abstract
BACKGROUND Previous studies predominantly focused on single types of congenital birth defects (CBDs) or specific national prevalence. This study adopts a holistic perspective to assess current trends and health inequalities in birth incidence rate of various types of CBDs, providing novel insights to inform public health policy formulation. METHODS Global, socio-demographic index (SDI) regional, and country-specific estimates incidence cases and rate at birth of CBDs from 1990 to 2021 were derived from the Global Burden of Disease (GBD) 2021. Joinpoint analysis and autoregressive integrated moving average predictive models were employed to evaluate temporal trends in the birth incidence rate of CBDs for the period 2022-2031. Additionally, analysis of associations and health inequalities were conducted to examine the relationship between SDI and the birth incidence rate of CBDs across countries. RESULTS Globally, the birth incidence rate decreased from 5811.17/100k population in 1990 to 5563.72/100k population in 2021, with low SDI regions recording the lowest rate and cases. Joinpoint analysis revealed a global decrease in the birth incidence rate of CBDs (average annual percentage change, AAPC: -0.14%, 95%CI: -0.15% to -0.12%). The most significant decline was observed in neural tube defects (NTD) (AAPC: -1.35%, 95%CI: -1.42% to -1.28%). However, only birth incidence rate of orofacial clefts (OC) is projected to decrease globally the next decade. Within the five SDI regions, the birth incidence rate of OC is also projected to decrease probably. The analysis revealed negative correlations between congenital heart anomalies (CHA), NTD, and SDI, with NTD showing both absolute and relative health inequalities. CONCLUSIONS Despite the general decline in overall birth incidence rate of CBDs, projections suggested a probable increasing trend for all types except OC. This underscores the necessity for enhanced surveillance and intervention measures. Furthermore, the successful prevention policies implemented for NTD could serve as effective models for addressing other types of CBDs, thereby improving the current global situation of CBDs.
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Affiliation(s)
- Hanjun Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Kebin Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Xiaorui Ruan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jianhui Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jiapeng Tang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Liuxuan Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China.
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Norelli JB, Plaza D, Villamizar JM. Prepyloric gastric antral muscular ring in an infant. Clin J Gastroenterol 2024; 17:824-827. [PMID: 39080179 DOI: 10.1007/s12328-024-02010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 06/22/2024] [Indexed: 09/28/2024]
Abstract
We present a unique case of a prepyloric gastric muscular ring, a pathology distinct from a gastric web. There is scarcity of literature on this topic, nearly all cases of prepyloric antral rings or webs published in literature are mucosal or submucosal in nature with no evidence of muscle hypertrophy. Given the prevalence of pyloric stenosis as the most common gastric outlet malformation in neonates, gastric rings and webs are not readily considered in the differential diagnosis of gastric outlet obstruction. While most cases of gastric outlet obstruction are diagnosed radiologically, less common pathologies will be confirmed with direct visual inspection during surgery. The term "congenital gastric outlet obstruction" has been used to encompass rare cases, making it appropriate to include a muscular ring in this category. We propose the term "gastric ring" be used with a semantic modifier of "muscular" versus "submucosal/mucosal" to avoid confusion.
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Affiliation(s)
- Jolanta B Norelli
- Department of Diagnostic Radiology, Stony Brook University Hospital, Stony Brook, NY, USA.
| | - Dawid Plaza
- Department of Pediatrics, Maria Fareri Children's Hospital, Westchester Medical Center Health Network, Valhalla, NY, USA
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Rubesova E, Moeremans M. MR Imaging of the Fetal Gastrointestinal Anomalies. Magn Reson Imaging Clin N Am 2024; 32:489-496. [PMID: 38944436 DOI: 10.1016/j.mric.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Fetal MR imaging has been shown to be a useful tool for the diagnosis of fetal gastro-intestinal pathologies. To recognize the various pathologies, it is, however, essential to know the normal MR imaging appearance of the fetal bowel at various gestational ages. By providing additional information to ultrasound in case of a fetal gastrointestinal anomaly, MR imaging helps to improve planning for the delivery, postnatal management, and improves parental counseling.
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Affiliation(s)
- Erika Rubesova
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, 725 Welch Road, Palo Alto, CA 94304, USA.
| | - Marine Moeremans
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, 725 Welch Road, Palo Alto, CA 94304, USA
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Akomea-Agyin E, Agbedinu K, Dally CK, Galley F, Kankam EO, Banini GE. Duodenal stenosis in adult malrotation: When Ladd procedure is not enough: A case report. Int J Surg Case Rep 2024; 119:109713. [PMID: 38703614 PMCID: PMC11087998 DOI: 10.1016/j.ijscr.2024.109713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/25/2024] [Indexed: 05/06/2024] Open
Abstract
INTRODUCTION Congenital causes of duodenal obstruction can be grouped into intrinsic and extrinsic causes. The degree of obstruction caused by such etiologies determines the severity and timing of symptom presentation. Early neonatal diagnosis is common in patients with etiologies that present with high degrees of obstruction such as atresia whereas etiologies that cause lesser degrees of obstruction such as malrotation and duodenal stenosis can go undiagnosed into adulthood. PRESENTATION OF CASE We report a case of a 24-year-old female who presented with acute on chronic abdominal pain with bilious vomiting. She was diagnosed with intermittent small bowel volvulus which resolved spontaneously but was found to have adult intestinal malrotation diagnosed intraoperatively. She had a Ladd procedure done but had persistent obstructive small bowel symptoms after the Ladd procedure. She was found to have duodenal stenosis from fibrosis of the duodenum on relaparotomy which was treated surgically with Heineke-Mikulicz strictureplasty leading to total resolution of symptoms. DISCUSSION Congenital extrinsic and intrinsic causes of partial duodenal obstruction such as Ladd bands in malrotation and duodenal stenosis respectively, can co-exist and persist into adulthood due to their lesser symptomatology and degree of obstruction. Surgical treatment must identify and correct both conditions when they co-exist to ensure complete resolution of symptoms. CONCLUSION This case report highlights the association of duodenal stenosis with adult malrotation which may account for persistent symptoms after the Ladd procedure and suggests the use of Heineke-Mikulicz strictureplasty as a complementary procedure for complete symptom resolution.
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Affiliation(s)
- Ebenezer Akomea-Agyin
- Komfo Anokye Teaching Hospital, Directorate of Surgery, P.O. Box 1934, Kumasi, Ghana.
| | - Kwabena Agbedinu
- Komfo Anokye Teaching Hospital, Directorate of Surgery, P.O. Box 1934, Kumasi, Ghana
| | - Charles Kofi Dally
- Komfo Anokye Teaching Hospital, Directorate of Surgery, P.O. Box 1934, Kumasi, Ghana
| | - Fareeda Galley
- Komfo Anokye Teaching Hospital, Pediatric Surgery Unit, P.O. Box 1934, Kumasi, Ghana
| | - Emmanuel Osei Kankam
- Komfo Anokye Teaching Hospital, Directorate of Surgery, P.O. Box 1934, Kumasi, Ghana
| | - Gabriel Edudzi Banini
- Komfo Anokye Teaching Hospital, Directorate of Surgery, P.O. Box 1934, Kumasi, Ghana
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Zaiem A, Atri S, Fteriche FS, Frikha W, Haddad A, Kacem M. Ileal duplication in adults: A rare case. Int J Surg Case Rep 2024; 118:109606. [PMID: 38615468 PMCID: PMC11033146 DOI: 10.1016/j.ijscr.2024.109606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Intestinal duplication is an uncommon congenital malformation affecting the alimentary tract. This article presents a case of enteric duplication cyst (EDC) in an adult, accompanied by a review of the available literature. CASE PRESENTATION A 34-year-old woman with polymyositis underwent a routine CT scan as part of her medical assessment revealing an 8 cm mass near the caecum and terminal ileum. Diagnostic procedures confirmed a cystic spherical mass. The patient underwent ileo-cecal resection, with primary anastomosis and an uneventful recovery. CLINICAL DISCUSSION Studies indicate that the frequency of polymyositis coexisting with a neoplasm range from 6 % to 40 %. Therefore, a body CT scan is recommended for patients with myopathy as in our patient. Intestinal duplications are predominantly found in children but can also occur in adults, often discovered incidentally or due to complications. Diagnostic imaging techniques, such as ultrasonography and CT scan, are crucial in identifying duplication location and characteristics. In this case, colonoscopy indicated ileocecal valve compression, and histological examination confirmed an enteric duplication cyst with ectopic gastric mucosa. CONCLUSION Enteric duplication cysts are rare, and the existing literature on the topic somewhat limited. Early diagnosis and surgical intervention are essential to stave off potential complications and reduce morbidity. Clinician awareness of enteric duplication cysts enables timely management, enhancing patient outcomes. Further research is needed to improve understanding and optimize patient care.
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Alsinan TA, Altokhais TI. Multiple thoracic and abdominal foregut duplication cysts: A case report. World J Clin Cases 2024; 12:1504-1509. [PMID: 38576813 PMCID: PMC10989454 DOI: 10.12998/wjcc.v12.i8.1504] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/19/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Congenital enteric duplication cysts are tubular or cystic structures that normally lie alongside the gastrointestinal (GI) tract. Enteric duplication cysts are typically solitary lesions that occur anywhere near the GI tract from the neck to the rectum, but having multiple duplication cysts is rare, and presentation within the pancreas is extremely rare. CASE SUMMARY We herein demonstrate a case of esophageal, gastric, and gastric-type duplication cyst of the pancreas in a seventeen-month-old girl who presented with failure to thrive, abdominal pain, vomiting, hematemesis, and melena since the age of three months. The cysts were excised by thoracoscopy and laparoscopy in the same setting. To our knowledge, no such case has been published. CONCLUSION Enteric duplications can occur throughout the entire alimentary tract. When they occur in the pancreas, they present a formidable challenge in both diagnosis and treatment. Due to the risk of complications and malignant transformation, surgical removal is the recommended treatment of all duplication cysts.
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Affiliation(s)
- Tuqa Adil Alsinan
- Department of Pediatric Surgery, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Tariq Ibrahim Altokhais
- Devision of Pediatric Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 4545, Saudi Arabia
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Jayakumar TK, Rathod KJ, Sinha A, Yadav T. Nonhypertrophic Pyloric Stenosis in a Neonate: A Rare Presentation. J Indian Assoc Pediatr Surg 2023; 28:421-424. [PMID: 37842226 PMCID: PMC10569279 DOI: 10.4103/jiaps.jiaps_157_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/22/2023] [Accepted: 03/03/2023] [Indexed: 10/17/2023] Open
Abstract
Gastric outlet obstruction in neonates due to nonhypertrophic pyloric stenosis (NHPS) is a rare cause. We report the case of a 37-day-old baby boy who presented with complaints of vomiting for the last 2 weeks and an inconsolable cry over the last 2 days. He has been vomiting seven to eight times a day, a few hours after breastfeeding. On ultrasonography, the stomach was distended, while the pylorus was not hypertrophied. An upper gastrointestinal (GI) contrast study was done, which was suggestive of gastric volvulus. We performed a laparoscopy for the same. Intraoperatively, the volvulus was already resolved. We performed gastropexy. Postoperatively, he had persistent symptoms, for which an upper GI endoscopy was performed. It demonstrated a narrow pylorus, consistent with the NHPS. We performed a laparoscopic Heineke-Mikulicz pyloroplasty. The patient's symptoms had improved postoperatively. He was discharged after 5 days.
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Affiliation(s)
- T. K. Jayakumar
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kirtikumar J Rathod
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Arvind Sinha
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Taruna Yadav
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Abstract
Radiologic evaluation of neonatal bowel obstruction is challenging owing to the overlapping clinical features and imaging appearances of the most common differential diagnoses. The key to providing an appropriate differential diagnosis comes from a combination of the patient's gestational age, clinical features, and imaging findings. While assessment of radiographs can confirm bowel obstruction and indicate whether it is likely proximal or distal, additional findings at upper or lower gastrointestinal contrast study together with use of US are important in providing an appropriate differential diagnosis. The authors provide an in-depth assessment of the appearances of the most common differential diagnoses of proximal and distal neonatal bowel obstruction at abdominal radiography and upper and lower gastrointestinal contrast studies. These are divided into imaging patterns and their associated differential diagnoses on the basis of abdominal radiographic findings. These findings include esophageal atresia variants including the "single bubble," "double bubble," and "triple bubble" and distal bowel obstruction involving the small and large bowel. Entities discussed include esophageal atresia, hypertrophic pyloric stenosis, pyloric atresia, duodenal atresia, duodenal web, malrotation with midgut volvulus, jejunal atresia, ileal atresia, meconium ileus, segmental volvulus, internal hernia, colonic atresia, Hirschsprung disease, and functional immaturity of the large bowel. The authors include the advantages of abdominal US in this algorithm, particularly for hypertrophic pyloric stenosis, duodenal web, malrotation with midgut volvulus, and segmental volvulus. ©RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.
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Affiliation(s)
- Samantha K Gerrie
- From the Department of Radiology, BC Children's Hospital, 4500 Oak St, Vancouver, BC, Canada V6H 3N1, and Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (S.K.G.); and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada, and Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (O.M.N.)
| | - Oscar M Navarro
- From the Department of Radiology, BC Children's Hospital, 4500 Oak St, Vancouver, BC, Canada V6H 3N1, and Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (S.K.G.); and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada, and Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (O.M.N.)
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Sirichamratsakul K, Laochareonsuk W, Surachat K, Sangkhathat S. Population-based prevalence study of common congenital malformations of the alimentary tract and abdominal wall in Thailand: a study using data from the National Health Security Office. WORLD JOURNAL OF PEDIATRIC SURGERY 2023; 6:e000540. [PMID: 37303481 PMCID: PMC10254801 DOI: 10.1136/wjps-2022-000540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/09/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND The study aimed to estimate the prevalence of major congenital anomalies of the alimentary system and the abdominal wall in Thailand using a nationwide hospital discharge database from the National Health Security Office (2017-2020). METHODS The study extracted data from records with International Classification of Diseases-10 (ICD-10) codes related to esophageal malformation (ESO), congenital duodenal obstruction (CDO), jejunoileal atresia (INTES), Hirschsprung's disease (HSCR), anorectal malformation (ARM), abdominal wall defects (omphalocele (OMP) and gastroschisis (GAS)), and diaphragmatic hernia from the database with patient age selection set to less than 1 year. RESULTS A total of 2539 matched ICD-10 records were found in 2376 individuals over the 4-year study period. Concerning foregut anomalies, the prevalence of ESO was 0.88/10 000 births, while that of CDO was 0.54/10 000 births. The prevalence figures of INTES, HSCR, and ARM were 0.44, 4.69, and 2.57 cases per 10 000 births, respectively. For abdominal wall defects, the prevalences of OMP and GAS were 0.25 and 0.61 cases/10 000 births, respectively. The mortality in our cases was 7.1%, and survival analysis found that associated cardiac defects had a statistically significant influence on survival in most anomalies studied. In HSCR, both Down syndrome (DS) (hazard ratio (HR)=7.57, 95% confidence interval (CI)=4.12 to 13.91, p<0.001) and cardiac defects (HR=5.82, 95% CI=2.85 to 11.92, p<0.001) were significantly associated with poorer survival outcomes. However, only DS (adjusted HR=5.55, 95% CI=2.63 to 11.75, p<0.001) independently predicted worse outcomes by multivariable analysis. CONCLUSIONS Our analysis of the hospital discharge database found that the prevalence of gastrointestinal anomalies in Thailand was lower than that reported in other countries, except for HSCR and anorectal malformations. Associated Down syndrome and cardiac defects influence the survival outcomes of these anomalies.
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Affiliation(s)
| | - Wison Laochareonsuk
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
- Translational Medicine Research Center, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Komwit Surachat
- Translational Medicine Research Center, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
- Department of Biomedical Sciences and Biomedical Engineering, Prince of Songkla University, Hat Yai, Thailand
| | - Surasak Sangkhathat
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
- Translational Medicine Research Center, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
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Laabidi S, Ben Mohamed A, Khsiba A, Yakoubi M, Mahmoudi M, Medhioub M, Hamzaoui L, Azouz MM. Acquired double pylorus presenting as a gastrointestinal bleeding. Clin Case Rep 2022; 10:e05634. [PMID: 35340641 PMCID: PMC8935129 DOI: 10.1002/ccr3.5634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/14/2022] [Accepted: 03/07/2022] [Indexed: 11/07/2022] Open
Abstract
We present the case of a 65-year-old man without a past medical history who was admitted for gastrointestinal bleeding. The case shows an acquired double pylorus due to probable pre pyloric ulcer.
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Affiliation(s)
- Sarra Laabidi
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Asma Ben Mohamed
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Amal Khsiba
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Manel Yakoubi
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Moufida Mahmoudi
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Mouna Medhioub
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Lamine Hamzaoui
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Mohamed Mssadak Azouz
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
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Hunt TM, Thacker PG. Sonographic Detection of Congenital Intestinal Malrotation: A Case Report. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2021. [DOI: 10.1177/87564793211037612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Intestinal malrotation is a rare fetal anomaly resulting from the failure of midgut rotation and fixation. Sonography is typically the first modality of choice for assessing pediatric pathology due to its high sensitivity, portability, real-time imaging capability, and non-ionizing technique; however, its role in diagnosing small bowel rotational anomalies remains limited and controversial. Fluoroscopic upper gastrointestinal imaging (UGI) is the primary diagnostic examination at most institutions. However, even on UGI, imaging findings may be equivocal. In such cases, sonography may provide additional information at facilities where it is not used as a primary diagnostic tool. This case report represents the first reported case showing how patient position is important as the typical vascular sonographic features of rotation were normal in one position but abnormal in another. In addition, this case shows how congenital intestinal malrotation was decisively diagnosed using sonographic imaging.
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Abstract
Esophageal atresia (EA) is the most common congenital esophageal disorder. Radiological imaging facilitates diagnosis, surgical interventions, and follow-up. Despite this, standardized monitoring guidelines are lacking. We aimed to: (1) review the literature regarding radiation burden in children with EA; (2) establish the presence of guidelines for diagnosis and follow-up in children with EA. The systematic review was performed according to PRISMA protocol. Two investigators conducted independent searches (PubMed, Ovid, Cochrane Review) and data extraction. Analysis focused on pre- and post-operative imaging type and frequency to determine the radiation burden. Seven studies met the inclusion criteria (337 patients). All authors agreed upon the need to minimize radiation burden, recommending symptoms-guided management, use of dosimeters, and non-radiating imaging. One study identified a median 130-fold increase in cumulative lifetime cancer risk in children with EA compared with other babies in the special care unit. The most common investigations were X-ray and CT (pre-operatively), and X-ray and contrast swallow (post-operatively). Standardized guidelines focused upon the frequency and type of radiological imaging for children with EA are lacking. Children with EA are subjected to more radiation exposure than the general population. Implementation of non-radiating imaging (ultrasonography, manometry) is recommended.
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D'Agostino V, Castaldo A, Catelli A, Pesce I, Genovese S, Coppola L, Monaci A, Esposito C, Amitrano M. An ileal duplication cyst case report: From diagnosis to treatment. Radiol Case Rep 2021; 16:1597-1602. [PMID: 33995750 PMCID: PMC8102431 DOI: 10.1016/j.radcr.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 12/30/2022] Open
Abstract
Enteric duplication cysts (EDCs) are rare congenital malformations of the children and can develop everywhere along the gastrointestinal (GI) tract, being the ileum the most frequent localization. We herein present an unusual case of duplication cyst of ileal origin who show a tubular morphology and doesn't communicate with GI lumen. A 2-month-old boy was admitted to our hospital for investigation of an anechoic formation of the lower right abdomen for the surgical planning. The patient was asymptomatic. Ultrasound (US) and magnetic resonance imaging (MRI) showed features of a cystic lesion. Laparoscopic surgery was performed and the cyst excised. Macroscopic examination and histologic findings confirmed the diagnosis of a enteric duplication cyst arising from the ileum. In a patient with an abdominal cystic mass, although asymptomatic, it's worth assessing the nature of the lesion and planning a surgery in order to avoid future complications. A correct use of diagnostic it's fundamental to identify the etiology and the characteristics of a cystic mass.
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Affiliation(s)
- Valerio D'Agostino
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Anna Castaldo
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Antonio Catelli
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Ilaria Pesce
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Stefano Genovese
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Luigi Coppola
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Alessandro Monaci
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Ciro Esposito
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Michele Amitrano
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
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Munden MM, Paltiel HJ. The Gastrointestinal Tract. PEDIATRIC ULTRASOUND 2021:283-353. [DOI: 10.1007/978-3-030-56802-3_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Late diagnosis of duodenal obstruction associated with down syndrome: Similar presentation of different pathologies. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Symptomatic duodenal web diagnosed in a young adult. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Debnath P, Udgirkar S, Rathi P, Jain S, Nair S, Pawar V, Contractor Q. Esophageal Mucosal Bridge of Unknown Etiology Causing Dysphagia in an Elderly Female: Endoscopic Management and Literature Review. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2020; 27:356-360. [PMID: 32999908 PMCID: PMC7506287 DOI: 10.1159/000505034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/26/2019] [Indexed: 06/11/2023]
Abstract
Esophageal mucosal bridge is an elastic stretchable structure, connecting across the lumen, extending either obliquely or horizontally, more commonly seen in the mid or lower esophagus. It can be either congenital or secondary (acquired). Acquired ones are secondary to reflux esophagitis, corrosive esophageal injury, drug-induced esophagitis, radiation esophagitis, Crohn's disease, Mallory-Weiss syndrome, malignant tumors, and infections like candidiasis, HSV, CMV, or tuberculosis. We present a case of an elderly female, who presented with progressive dysphagia for 3 months, more commonly to solids without any history of anorexia or weight loss. No history of corrosive ingestion, radiation exposure, or prior history of any surgical or endoscopic intervention was present. Upper gastrointestinal endoscopy revealed esophageal mucosal bridge at 20 and 25 cm from incisors and mucosal tag. Endoscopic resection was carried out successfully with hot biopsy forceps and needle knife after prophylactic application of hemoclips at two ends of each bridge, without any adverse event. Esophageal mucosal bridge, though rarely reported, should be kept in the differential diagnosis of patients presenting with dysphagia. Endoscopic resection with hot biopsy forceps or needle knife seems to be effective.
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Affiliation(s)
- Prasanta Debnath
- *Dr. Prasanta Debnath, T.N.M.C. and B.Y.L. Nair Charitable Hospital, Room No. 717, 7th Floor, OPD Building, Dr. A.L. Nair Road, Mumbai Central, Mumbai, Maharashtra 400008 (India), E-Mail
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Win MKK, Mensah C, Kaushik K, Pierre L, Adeyinka A. Duodenal Stenosis: A Diagnostic Challenge in a Neonate With Poor Weight Gain. Cureus 2020; 12:e8559. [PMID: 32670696 PMCID: PMC7358904 DOI: 10.7759/cureus.8559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cases of isolated duodenal stenosis in the neonatal period are minimally reported in pediatric literature. Causes of small bowel obstruction such as duodenal atresia or malrotation with midgut volvulus have been well documented and are often diagnosed due to their acute clinical presentation. Duodenal stenosis, however, causes an incomplete intestinal obstruction with a more indolent and varying clinical presentation thus making it a diagnostic challenge. We present a neonate with a unique case of congenital duodenal stenosis. The neonate presented with poor weight gain and frequent "spit-ups" as per the mother at the initial newborn visit. The clinical presentation was masked as the patient was being fed infrequently and with concentrated formula. We postulate that this may be due to the fact that the mother was an adolescent and relatively inexperienced with newborn care. During the hospital course, the patient had recurrent episodes of emesis with notable electrolyte abnormalities including hypochloremia and metabolic alkalosis. Further investigation with an abdominal X-ray showed dilated loops of bowel. Pyloric stenosis was ruled out via abdominal ultrasound. An upper gastrointestinal (GI) series ultimately confirmed a diagnosis of duodenal stenosis and the infant underwent surgical repair with full recovery. Congenital duodenal stenosis may have atypical presentations in neonates requiring pediatricians to have a high index of suspicion for diagnosis and to ensure timely therapy.
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Wang MX, Baxi A, Rajderkar D. Pictorial review of non-traumatic thoracic emergencies in the pediatric population. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0012-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Griffin S. Feline abdominal ultrasonography: What's normal? What's abnormal? The diseased gastrointestinal tract. J Feline Med Surg 2019; 21:1047-1060. [PMID: 31648606 PMCID: PMC10814209 DOI: 10.1177/1098612x19880434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. B-mode ultrasonography is likely the most widely used modality for imaging the gastrointestinal (GI) tract in cats and it can help in the diagnosis of GI masses, foreign bodies and disorders of the ileocaecocolic junction. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variations and pathological changes can be challenging for all but the most experienced. For example, while for inflammatory conditions of the feline GI tract changes are frequently identified on ultrasound, there may occasionally be no changes to the appearance of the intestine; hence a 'normal' ultrasound does not exclude the possibility of inflammatory disease. AIM This review, part of an occasional series on feline abdominal ultrasonography, describes the appearance of a range of conditions that affect the feline GI tract; the normal GI tract is addressed in an accompanying article in this issue of JFMS. Aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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21
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The Pediatric Esophagus. Dysphagia 2018. [DOI: 10.1007/174_2018_180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Khanna S, Gupta P, Khanna R, Dalela D. Distal Duodenal Obstruction: a Surgical Enigma. Indian J Surg 2017; 79:245-253. [PMID: 28659679 DOI: 10.1007/s12262-017-1604-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 02/23/2017] [Indexed: 02/07/2023] Open
Abstract
The postbulbar segment also known as the distal duodenum is a separate clinical entity in terms of the intrinsic pathologies of this region and its varied anatomical relations. The common bile duct and the pancreatic duct open through the major papilla, which marks the beginning of this segment. Distal duodenal obstruction can be defined as a clinicoradiological entity that is characterized by features of gastric outlet obstruction with recurrent bilious vomiting and a radiological evidence of postbulbar obstruction. A Medline search for distal duodenal obstruction revealed 1409 entries, mostly in the form of case reports. In the last 10 years, 310 cases are reported. Clinical features like abdominal pain, nausea, and vomiting are non-specific and quite similar to gastric outlet obstruction. Clinical findings are also non-specific and do not aid in diagnosis. Laboratory findings also do not add much. Contrast-enhanced CT scan and MR enterography are diagnostic modalities of choice. Distal duodenal obstruction is a clinical entity that has a wide list of differential diagnosis which requires due consideration in terms of its management and follow-up. Most of these lesions require adequate workup with the help of a multidisciplinary team consisting of radiologists, gastroenterologists, and pathologists to adequately diagnose and stage the disease before a treatment plan is formulated. A thorough knowledge is a must regarding the treatment options available for each of the conditions so that the management can be personalized leading to better results.
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Affiliation(s)
- Seema Khanna
- Department of General Surgery, Institute of Medical Sciences, BHU, Varanasi, 221005 India
| | - Piyush Gupta
- Department of General Surgery, Institute of Medical Sciences, BHU, Varanasi, 221005 India
| | - Rahul Khanna
- Department of General Surgery, Institute of Medical Sciences, BHU, Varanasi, 221005 India
| | - Disha Dalela
- Institute of Medical Sciences, BHU, Varanasi, India
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23
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Imaging spectrum of nonneoplastic duodenal diseases. Clin Imaging 2016; 40:1173-1181. [DOI: 10.1016/j.clinimag.2016.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/08/2016] [Accepted: 08/02/2016] [Indexed: 12/26/2022]
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Ultrasound of the duodenum in children. Pediatr Radiol 2016; 46:1324-31. [PMID: 27003134 DOI: 10.1007/s00247-016-3564-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 01/06/2016] [Accepted: 01/26/2016] [Indexed: 10/22/2022]
Abstract
Ultrasound is well suited for examining the pediatric duodenum, given the small size of the patients, the lack of ionizing radiation and high-resolution imaging potential. Technical considerations, normal anatomy, congenital and acquired pathology of the duodenum, and the advantages and limitations of US are discussed and illustrated in this review.
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Brinkley MF, Tracy ET, Maxfield CM. Congenital duodenal obstruction: causes and imaging approach. Pediatr Radiol 2016; 46:1084-95. [PMID: 27324508 DOI: 10.1007/s00247-016-3603-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 01/25/2016] [Accepted: 03/01/2016] [Indexed: 12/14/2022]
Abstract
Bilious emesis is a common cause for evaluation in pediatric radiology departments. There are several causes of congenital duodenal obstruction, most of which require elective surgical correction, but the potential of malrotation with midgut volvulus demands prompt imaging evaluation. We review the various causes of congenital duodenal obstruction with an emphasis on the approach to imaging evaluation and diagnosis.
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Affiliation(s)
- Michael F Brinkley
- Department of Radiology, Duke University Medical Center, DUMC Box 3808, Durham, NC, 27710, USA.
| | - Elisabeth T Tracy
- Division of Pediatric Surgery, Duke University Medical Center, Durham, NC, USA
| | - Charles M Maxfield
- Department of Radiology, Duke University Medical Center, DUMC Box 3808, Durham, NC, 27710, USA
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El-Malah HEDGM, Radwan MEEDM, Ali AM, Shaaraway METE. Utility of 64-row MDCT in assessment of neonates with congenital EA and distal TEF. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2015.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Dusunceli Atman E, Erden A, Ustuner E, Uzun C, Bektas M. MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations. Korean J Radiol 2015; 16:1240-52. [PMID: 26576112 PMCID: PMC4644744 DOI: 10.3348/kjr.2015.16.6.1240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 07/16/2015] [Indexed: 12/22/2022] Open
Abstract
This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.
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Affiliation(s)
- Ebru Dusunceli Atman
- Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey
| | - Ayse Erden
- Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey
| | - Evren Ustuner
- Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey
| | - Caglar Uzun
- Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey
| | - Mehmet Bektas
- Department of Gastroenterology, Ankara University School of Medicine, Ankara 06100, Turkey
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McNeeley MF, Lalwani N, Dhakshina Moorthy G, Maki J, Dighe MK, Lehnert B, Prasad SR. Multimodality imaging of diseases of the duodenum. ABDOMINAL IMAGING 2014; 39:1330-1349. [PMID: 24811767 DOI: 10.1007/s00261-014-0157-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The duodenum is a unique segment of intestine, occupying both intra and extra-peritoneal locations. There is a wide spectrum of abnormalities of the duodenum that range from congenital anomalies to traumatic, inflammatory, and neoplastic entities. The duodenum may be overlooked on cross-sectional imaging due to its location and small size. Duodenal pathologies may, therefore, be missed or wrongly diagnosed. Knowledge about duodenal pathologies and optimal imaging techniques can increase diagnostic yield and permit optimal patient management. Conventionally, the duodenum was evaluated with upper GI studies on fluoroscopy; however, endoluminal evaluation is better performed with endoscopy. Additionally, a broad array of cross-sectional imaging modalities permits comprehensive assessment of the duodenum and surrounding viscera. While endoscopic sonography is increasingly used to locally stage duodenal malignancies, MDCT remains the primary modality widely used in the detection and characterization of duodenal abnormalities. MRI is used as a "problem solving" modality in select conditions. We present a comprehensive review of duodenal abnormalities with an emphasis on accurate diagnosis and management.
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Abstract
Chest pain in children is commonly caused by benign etiologies but may be caused by conditions that carry significant morbidity if not treated. Emergency medicine physicians must identify the patients that require further evaluation and treatment. We describe a case of a 13-year-old boy with 10 months of progressive chest pain that had been attributed to anxiety and was ultimately diagnosed as an esophageal duplication cyst requiring surgical repair.
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30
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Laskowska K, Gałązka P, Daniluk-Matraś I, Leszczyński W, Serafin Z. Use of diagnostic imaging in the evaluation of gastrointestinal tract duplications. Pol J Radiol 2014; 79:243-50. [PMID: 25114725 PMCID: PMC4128324 DOI: 10.12659/pjr.890443] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 01/28/2014] [Indexed: 12/12/2022] Open
Abstract
Background Gastrointestinal tract duplication is a rare malformation associated with the presence of additional segment of the fetal gut. The aim of this study was to retrospectively review clinical features and imaging findings in intraoperatively confirmed cases of gastrointestinal tract duplication in children. Material/Methods The analysis included own material from the years 2002–2012. The analyzed group included 14 children, among them 8 boys and 6 girls. The youngest patient was diagnosed at the age of three weeks, and the oldest at 12 years of age. Results The duplication cysts were identified in the esophagus (n=2), stomach (n=5), duodenum (n=1), terminal ileum (n=5), and rectum (n=1). In four cases, the duplication coexisted with other anomalies, such as patent urachus, Meckel’s diverticulum, mesenteric cyst, and accessory pancreas. Clinical manifestation of gastrointestinal duplication cysts was variable, and some of them were detected accidently. Thin- or thick-walled cystic structures adjacent to the wall of neighboring gastrointestinal segment were documented on diagnostic imaging. Conclusions Ultrasound and computed tomography are the methods of choice in the evaluation of gastrointestinal duplication cysts. Apart from the diagnosis of the duplication cyst, an important issue is the detection of concomitant developmental pathologies, including pancreatic heterotopy.
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Affiliation(s)
- Katarzyna Laskowska
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Przemysław Gałązka
- Department and Clinic of Pediatric Surgery, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Irena Daniluk-Matraś
- Department and Clinic of Pediatric Surgery, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Waldemar Leszczyński
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
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31
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Tsai SD, Sopha SC, Fishman EK. Isolated duodenal duplication cyst presenting as a complex solid and cystic mass in the upper abdomen. J Radiol Case Rep 2014; 7:32-7. [PMID: 24421928 DOI: 10.3941/jrcr.v7i11.1785] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Duodenal duplication cysts are a rare subtype of gastrointestinal duplications cysts. Approximately 5% of gastrointestinal duplication cysts occur in the duodenum. An 18-year-old woman presented with epigastric pain and a subjective abdominal bulge. A computed tomography scan was subsequently performed and showed a solid and cystic mass with wall calcifications in the lesser sac of the upper abdomen. A duodenal duplication cyst was found unexpectedly on histopathologic analysis. This was also an unusual case as there was no evidence of malignancy. Four years after surgery, the patient remains asymptomatic. We present a brief literature review on duodenal duplication cysts and discuss its differential diagnosis.
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Affiliation(s)
- Salina D Tsai
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Sabrina C Sopha
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Elliot K Fishman
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Virmani V, Khandelwal A, Sethi V, Kielar A, Ryan J, Fasih N. Spectrum of imaging manifestations in non-neoplastic gastric pathologies. Curr Probl Diagn Radiol 2013; 42:127-34. [PMID: 23795991 DOI: 10.1067/j.cpradiol.2012.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article illustrates a wide spectrum of non-neoplastic gastric pathologies on cross-sectional imaging. Salient features of inflammatory, infectious, vascular, traumatic, and miscellaneous conditions of the stomach have been discussed and imaging clues to reach an accurate diagnosis are stressed upon.
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Affiliation(s)
- Vivek Virmani
- Department of Medical Imaging, The Ottawa hospital, Ottawa, Ontario, Canada
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Virmani V, Khandelwal A, Sethi V, Fraser-Hill M, Fasih N, Kielar A. Neoplastic stomach lesions and their mimickers: spectrum of imaging manifestations. Cancer Imaging 2012; 12:269-78. [PMID: 22935192 PMCID: PMC3458788 DOI: 10.1102/1470-7330.2012.0031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This review illustrates a wide spectrum of gastric neoplasms with emphasis on imaging findings helpful in characterizing various gastric neoplasms. Both the malignant and benign neoplasms along with focal gastric masses mimicking tumour are illustrated. Moreover, imaging clues to reach an accurate diagnosis are emphasized.
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35
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Abstract
The double pylorus is an uncommon finding and maybe congenital due to gastrointestinal duplication abnormality or more commonly secondary to peptic ulcer disease.
The case we present is an elderly patient with mild dyspeptic symptoms who had an upper endoscopy as part of her investigative workup.
The congenital double pylorus, being asymptomatic, may often go undetected. It is sometimes found incidentally on upper endoscopy, but needs no directed therapy. It is not associated with any specific complication.
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36
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Medsinge A, Bartoletti SC, Furtado A, Katz A, Tadros SS. Isolated intramuscular fibrous band masquerading antral web in a premature neonate. A case report. J Pediatr Surg 2012; 47:e17-9. [PMID: 22901937 DOI: 10.1016/j.jpedsurg.2012.03.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 03/19/2012] [Accepted: 03/20/2012] [Indexed: 01/08/2023]
Abstract
Isolated fibrous gastric antral band in a neonate causing partial gastric obstruction and mimicking prepyloric antral web is not reported in the English literature, and we would like to report the first case. A premature neonate with feeding difficulties and bilious aspirate underwent upper gastrointestinal contrast examination. The upper gastrointestinal series showed a thin, radiolucent, circumferential band in the antrum with delayed gastric emptying. Radiographic diagnosis of prepyloric antral web with partial gastric obstruction was made. Intraoperatively, a circumferential fibrous cord was found in the muscle layer (tunica muscularis) of the antrum, which was completely divided. Clinically and radiographically, the 2 conditions could not be differentiated but require 2 separate surgical techniques for their management.
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Affiliation(s)
- Avinash Medsinge
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Centre, Pittsburgh, PA 15224, USA.
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37
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"What is inside this right lower quadrant sac?" Spectrum of computed tomography abnormalities that affect the cecum. Can Assoc Radiol J 2012; 64:376-86. [PMID: 22579338 DOI: 10.1016/j.carj.2011.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 09/21/2011] [Accepted: 12/19/2011] [Indexed: 11/20/2022] Open
Abstract
The current pictorial is a comprehensive review of the various cecal pathologies, including both those that solely involve the cecum and those in which the cecum may be secondarily involved. The various cecal abnormalities will be categorized as inflammatory, infectious, vascular, neoplastic, congenital, and foreign bodies. Emphasis will be placed on the imaging features that, when coupled with the clinical history, help to reach a diagnosis or to narrow the differential diagnosis.
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38
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Benson JE. The Pediatric Esophagus. Dysphagia 2012. [DOI: 10.1007/174_2012_582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee NK, Kim S, Jeon TY, Kim HS, Kim DH, Seo HI, Park DY, Jang HJ. Complications of congenital and developmental abnormalities of the gastrointestinal tract in adolescents and adults: evaluation with multimodality imaging. Radiographics 2011; 30:1489-507. [PMID: 21071371 DOI: 10.1148/rg.306105504] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There is a wide variety of congenital anomalies that may affect the gastrointestinal tract. Most symptomatic congenital anomalies are found in newborns and infants. Such anomalies are relatively rare in adolescents and adults, and they may be difficult to identify because clinical symptoms often are nonspecific and insidious, causing them to be mistaken for other common abdominal conditions. Multimodality imaging is useful in evaluating congenital anomalies of the gastrointestinal tract in adults. The imaging features at radiography, fluoroscopy, ultrasonography, computed tomography, and magnetic resonance imaging may help identify congenital gastrointestinal anomalies such as congenital esophageal stenosis, gastric volvulus, duodenal web, annular pancreas, heterotopic pancreas, cecal volvulus, anomalies of the omphalomesenteric duct, Hirschsprung disease, and gastrointestinal duplication cyst. Familiarity with the imaging features of the various congenital anomalies of the gastrointestinal tract and their complications is important to establish the correct diagnosis and determine appropriate treatment, which is critical to avoid life-threatening complications.
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Affiliation(s)
- Nam Kyung Lee
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Pusan National University, Seo-Gu, Busan, Korea
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40
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Bach-Ségura P, Belarbi N. [Diagnostic imaging evaluation of neonatal vomiting]. ACTA ACUST UNITED AC 2011; 92:134-41. [PMID: 21352745 DOI: 10.1016/j.jradio.2010.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 12/07/2010] [Indexed: 10/18/2022]
Abstract
Vomiting during the neonatal period is frequent. The purpose is to detect neonates and infants with digestive pathology requiring urgent management such as duodenal atresia, small bowel volvulus, acute intussusception, and hypertrophic pyloris stenosis. All of these conditions may be diagnosed by ultrasound which should be performed when clinically suspected.
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Affiliation(s)
- P Bach-Ségura
- Maternité régionale de Nancy, service d'imagerie périnatale et de la femme, 10, rue du Dr-Heydenreich, 54042 Nancy cedex, France.
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41
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Annular pancreas: a rare cause of duodenal obstruction in adults. Indian J Surg 2010; 73:163-5. [PMID: 22468072 DOI: 10.1007/s12262-010-0150-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2010] [Accepted: 10/26/2010] [Indexed: 10/18/2022] Open
Abstract
Annular pancreas is an uncommon congenital anomaly which usually presents itself in infants and newborn. Rarely it can present in late adult life with wide range of clinical severities thereby making its diagnosis difficult. Pre-operative diagnosis is often difficult. CT scan can illustrate the pancreatic tissue encircling the duodenum. ERCP and MRCP are useful in outlining the annular pancreatic duct. Surgery still remains necessary to confirm diagnosis and bypassing the obstructed segment.We report a case of 61 year female presenting with duodenal obstruction due to annular pancreas.
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Maheshwari P, Abograra A, Shamam O. Sonographic evaluation of gastrointestinal obstruction in infants: a pictorial essay. J Pediatr Surg 2009; 44:2037-42. [PMID: 19853770 DOI: 10.1016/j.jpedsurg.2009.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 05/09/2009] [Accepted: 05/11/2009] [Indexed: 10/20/2022]
Abstract
Traditionally, gastrointestinal contrast studies have been the mainstay of evaluating infantile gastrointestinal problems. Because of technological advancements, good ultrasonography (USG) machines can provide high-resolution images with graphic anatomical clarity, especially in infants and children and thus change the traditional diagnostic trends. In this article, we illustrate the USG appearances of various causes of gastrointestinal obstruction in infants and discuss the role of USG in their evaluation.
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Vilela TT, Daher RT, Nóbrega MDA, Ximenes Filho CA, Montandon C, Montandon Júnior ME. Cistos congênitos do mediastino: aspectos de imagem. Radiol Bras 2009. [DOI: 10.1590/s0100-39842009000100012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Cistos congênitos mediastinais são lesões benignas incomuns, geralmente causadas por falhas no desenvolvimento embriológico do intestino anterior e/ou da cavidade celômica. São formações expansivas, comumente assintomáticas, mas que podem se manifestar principalmente pela compressão de estruturas adjacentes. Entre as principais entidades deste grupo temos: cistos broncogênico, pericárdico, entérico e tímico, linfangioma e cisto de duplicação esofágica. A morfologia dos cistos congênitos mediastinais é típica, sendo os exames de imagem suficientes, em grande parte dos casos, para a confirmação diagnóstica. O tratamento cirúrgico está indicado apenas nos casos sintomáticos, pois estas lesões não apresentam potencial de degeneração maligna. O objetivo deste trabalho é comentar e ilustrar os aspectos de imagem mais relevantes destas lesões, a partir do estudo retrospectivo de dez casos de arquivo das instituições envolvidas.
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Di Carlo I, Pulvirenti E, Toro A, Di Blasi M. Absence of pylorus: a rare gastric malformation. J Am Coll Surg 2008; 206:1224. [PMID: 18501822 DOI: 10.1016/j.jamcollsurg.2007.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Revised: 06/30/2007] [Accepted: 08/02/2007] [Indexed: 10/22/2022]
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Savino A, Rollo V, Chiarelli F. Congenital duodenal stenosis and annular pancreas: a delayed diagnosis in an adolescent patient with Down syndrome. Eur J Pediatr 2007; 166:379-80. [PMID: 17043846 DOI: 10.1007/s00431-006-0241-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2006] [Accepted: 06/29/2006] [Indexed: 11/24/2022]
Affiliation(s)
- Alessandra Savino
- Department of Pediatrics, Ospedale Policlinico, University of Chieti, Via dei Vestini 5, 66013, Chieti, Italy
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Uraz S, Aygün C, Konduk T, Celebi A, Sentürk O, Hülagü S. A rare gastric outlet anomaly: pyloric ostium on incissura angularis. Dig Dis Sci 2007; 52:1001-3. [PMID: 17342400 DOI: 10.1007/s10620-006-9228-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Accepted: 12/30/2005] [Indexed: 12/09/2022]
Abstract
Congenital gastric outlet anomalies are rarely seen defects resulting from early embryologic development of foregut. We report a case of congenital pyloric outlet anomaly in a 60-year-old man with mild postprandial epigastric discomfort of approximately 3 months' duration. Endoscopic examination of the stomach showed a pyloric ostium on incissura angularis connecting the stomach to the duodenum. Usual site of pylorus at the end of antrum was closed like a sac. No signs of acute or chronic peptic ulcer were noted. A biopsy was taken from the region showed normal mucosal layers with a mild gastritis. There was no history of surgery, ulcer disease, or use of any medication. The case was considered to be congenital in origin and was successfully treated conservatively with proton-pump inhibitors and gastrokinetics.
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Affiliation(s)
- Süleyman Uraz
- Department of Gastroenterology, Kocaeli University Medical Faculty, Kocaeli, Turkey
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Breysem L, Smet MH. Thoracic Emergencies. Emerg Radiol 2007. [DOI: 10.1007/978-3-540-68908-9_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cogollos J, Martínez MJ, Blanc E, Ripollés T, Calvillo P, Ballestín J. [Ultrasound and CT study of duodenal pathology]. RADIOLOGIA 2006; 48:263-72. [PMID: 17168235 DOI: 10.1016/s0033-8338(06)75135-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The radiological evaluation of the duodenum has traditionally been based on barium transit studies; however, ultrasound (US) and computed tomography (CT) are becoming more important in the assessment of this portion of the intestine and the structures that surround it. This report describes and illustrates the CT and US findings for different entities that affect the duodenum, including diseases of the duodenum itself and those of neighboring organs that affect this portion of the small intestine. We classify the pathologies by etiology into congenital, traumatic, iatrogenic and foreign bodies, bezoars, hematologic, inflammatory and neoplastic. Moreover, we present the incidental duodenal and periduodenal findings in US and CT that radiologists should be familiar with given the widespread use of these techniques.
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Affiliation(s)
- J Cogollos
- Servicio de Radiodiagnóstico, Hospital Universitario Dr. Peset, Valencia, España.
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Sutcliffe J, Munden M. Sonographic diagnosis of multiple gastric duplication cysts causing gastric outlet obstruction in a pediatric patient. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2006; 25:1223-6. [PMID: 16929026 DOI: 10.7863/jum.2006.25.9.1223] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Joseph Sutcliffe
- San Antonio Uniformed Services Health Education Consortium, 17807 Rockside Dr, TX 78258, USA.
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