An extremely rare cause of acute abdomen

Karaıslı, Serkan; Er, Ahmet; Örsel, Atilla; Kamer, Erdinç

doi:10.5152/tjg.2017.17081

Cited by 4 publications

(5 citation statements)

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“…Duodenal necrosis is a rare but lethal condition, with an almost 40% mortality rate [ 1 ]. With its rich blood supply, the incidence of isolated duodenal necrosis remains an enigma.…”

Section: Discussionmentioning

confidence: 99%

“…With its rich blood supply, the incidence of isolated duodenal necrosis remains an enigma. The previously-explained etiologies of duodenal ischemia include pancreatitis [ 5 , 6 ], vasculitis [ 2 ], caustic injury, trauma, Jejunal intussusception [ 1 ] or high loop obstruction [ 3 ], and perinephric abscess [ 7 ]. Nevertheless, the etiology remains unknown in some patients [ 4 , 6 ], similar to the present case.…”

Section: Discussionmentioning

confidence: 99%

“…This condition may manifest with acute abdomen, one of the most common presentations observed in clinical practice. The literature on this subject is scant and mainly limited to a few published case reports [ 1 – 5 ]. Here we describe an elderly patient with duodenal necrosis of unknown origin who presented to the emergency ward of a tertiary referral hospital.…”

Section: Introductionmentioning

confidence: 99%

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Isolated duodenal ischemia of unknown etiology: a case report

2021

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Background Acute abdomen is among the most common presentations observed in clinical practice. The present study describes a patient with isolated duodenal ischemia as an extremely rare etiology of acute abdomen. Case presentation A 79-year-old male with acute abdominal pain, nausea, and vomiting presented to the emergency department of our hospital. He was diagnosed with myelodysplastic syndrome 7 years ago, for which he took thalidomide and erythropoietin as the main medications. The prominent findings of the physical examination were hypotension, tachycardia, fever, mild hypoxemia, and epigastric and right upper quadrant tenderness of the abdomen. Except for mildly increased creatinine and lipase, other laboratory findings were in concordance with myelodysplastic syndrome. Due to the patient’s oliguria, the computed tomography (CT) scan was performed without contrast, which, together with the ultrasonography, raised the clinical impression of acute pancreatitis. The patient’s hypotension was refractive to supportive treatment, resulting in progressive deterioration of the clinical condition. A later contrast-enhanced CT scan suggested microvascular ischemia of the duodenum. An emergent Whipple’s procedure was planned initially, which was later switched to a damage control surgery due to the patient’s cardiac arrest during the surgery. Despite all the supportive therapy provided at the intensive care unit, the patient expired of a cardiac arrest which occurred two hours after the termination of the surgery. Conclusions The high rate of mortality in duodenal necrosis necessitates emergent diagnosis and proper management. When other common etiologies are ruled out, clinicians should consider duodenal pathology as a potential cause of acute abdomen.

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“…Duodenal necrosis is a rare but lethal condition, with an almost 40% mortality rate [ 1 ]. With its rich blood supply, the incidence of isolated duodenal necrosis remains an enigma.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Isolated duodenal ischemia of unknown etiology: a case report

2021

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“…The most common sites of infarction are the splenic flexure of the transverse colon and the proximal jejunum which is likely due to infarction of the feeding arteries [[2], [3], [4], [5], [6], [7], [8], [9]]. Duodenal necrosis is very uncommon site in this setting however it can occur given the shared blood supply to the head of the pancreas and the duodenum [10]. Other causes of duodenal necrosis are trauma, ingestion of corrosive substances, vasculitis and high jejunal obstruction [10].…”

Section: Introductionmentioning

confidence: 99%

“…Duodenal necrosis is very uncommon site in this setting however it can occur given the shared blood supply to the head of the pancreas and the duodenum [10]. Other causes of duodenal necrosis are trauma, ingestion of corrosive substances, vasculitis and high jejunal obstruction [10]. There are only a small number of case reports that discuss acute management in this situation [[11], [12], [13]].…”

Section: Introductionmentioning

confidence: 99%

Complete duodenal necrosis associated with non-traumatic duodenal hematoma requiring emergent pancreatico-duodenectomy

Koichopolos

Keow

Parfitt

et al. 2020

International Journal of Surgery Case Reports

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HighlightsDuodenal hematoma and necrosis should be recognized as part of the spectrum of consequences of acute pancreatitis.Surgical management is complex and challenging.General surgeons should have a surgical approach to this complication whether that be diversion or definitive resection.Definitive resection should be completed in multiple steps if there is extensive necrosis and the patient is clinically unwell.

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Warfarin

2017

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An extremely rare cause of acute abdomen

Cited by 4 publications

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Isolated duodenal ischemia of unknown etiology: a case report

Isolated duodenal ischemia of unknown etiology: a case report

Complete duodenal necrosis associated with non-traumatic duodenal hematoma requiring emergent pancreatico-duodenectomy

Warfarin

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