Duodenal diverticulum: incidental finding with potentially dangerous outcomes

Melnick, Sharon B.; Fareedy, Shoaib Bilal; Gish, David; Nazir, Salik

doi:10.1080/20009666.2017.1291784

Cited by 10 publications

(11 citation statements)

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“…Within the small bowel they occur most commonly in the duodenum [1]. Often they are asymptomatic and found incidentally via various means [2]. Duodenal diverticula have previously been found in 1–5% of barium examinations [1], 7% of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) [2] and 20% of autopsies [1].…”

Section: Discussionmentioning

confidence: 99%

“…Often they are asymptomatic and found incidentally via various means [2]. Duodenal diverticula have previously been found in 1–5% of barium examinations [1], 7% of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) [2] and 20% of autopsies [1]. Potential symptoms and complications of duodenal diverticula include pain, bleeding and obstruction of the bowel or biliary system.…”

Section: Discussionmentioning

confidence: 99%

“…Millard J et al [1] reported four cases of giant diverticula, two that measured 11 and 10 cm at initial diagnosis and two others described as ‘large’. Horst M, et al [4] presented a case report with a duodenal diverticulum measuring 6.8 × 4.5 × 1.8 cm with a number reporting ‘giant’ [3, 5] and ‘very large’ [2] diverticula among others.…”

Section: Discussionmentioning

confidence: 99%

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Giant duodenal diverticulum—an incidental finding

Bierton

Gupta

2019

Journal of Surgical Case Reports

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A 72-year-old female presented to the Emergency Department with 12 hours of non-specific epigastric pain. Her epigastrium was tender and inflammatory markers were mildly increased. A Computed Tomography scan revealed no acute pathology however there was a giant diverticulum arising from the second/third part of the duodenum measuring 9.5 × 5.7 × 7.3 cm. This was thought to be incidental, her pain settled and she was discharged. Diverticula are common throughout the gastrointestinal tract, predominantly in the colon. Within the small bowel they occur most commonly in the duodenum and are often asymptomatic and found incidentally. Potential complications of duodenal diverticula include pain, bleeding and obstruction. There are only a few cases reported of duodenal diverticula this large but it is important to be aware of them as a potential pathology and keep them and their associated complications as a differential for patients presenting with an acute abdomen.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Giant duodenal diverticulum—an incidental finding

Bierton

Gupta

2019

Journal of Surgical Case Reports

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“…Chomel [3]. It is not a particularly rare condition, affecting anywhere from 2-7% of the population [1] and is usually of little clinical significance [4]. However, it may present as diverticulitis, hemorrhage, malabsorption, or obstruction [1, 5].…”

Section: Discussionmentioning

confidence: 99%

Bile Salt Enterolith: An Unusual Etiology Mimicking Gallstone Ileus

Ferrari-Light

Shuchleib

Ricci-Gorbea

2018

Case Reports in Surgery

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Primary enterolithiasis is a relatively uncommon but important cause of small bowel obstruction. We present a case of a 69-year-old male with a history of laparoscopic Roux-en-Y gastric bypass and asymptomatic duodenal diverticulum diagnosed with small bowel obstruction. CT imaging showed an obstruction distal to the jejunojejunostomy, and surgical intervention was warranted. A 4.5 cm enterolith removed from the distal jejunum was found to contain 100% bile salts, consistent with a primary enterolith. Clinicians should retain a high index of suspicion for enteroliths as a cause of small bowel obstruction, especially if multiple risk factors for enterolith formation are present.

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“…Участие неспецифического звена иммунитета и роль нейтрофилов в канцерогенезе в настоящее время оцениваются неоднозначно [7,9,21]. Имеются данные о проопухолевом действии нейтрофильных гранулоцитов при злокачественной опухолевой прогрессии в виде активации неоангиогенеза, инвазии опухолевых клеток, индукции Т-клеточной иммуносупрессии [1,20,25,26]. Одновременно нейтрофилы являются эффекторными противоопухолевыми клетками.…”

Section: Introductionunclassified

Characteristics of neutrophilic granulocytes of peripheral blood in patients with mechanical jaundice caused by cholangiocarcinoma

et al. 2022

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Obstructive jaundice caused by cholangiocarcinoma takes a special place among malignant disorders and surgical pathology in Russia. Involvement of nonspecific immunity and the role of neutrophils in carcinogenesis are ambiguously evaluated. The aim of this study was to study functional activity of peripheral blood neutrophilic granulocytes and their phenotype in obstructive jaundice caused by cholangiocarcinoma. The study included 56 patients with obstructive jaundice associated with cholangiocarcinoma at the T2- 3N0- 1M0 stage (clinical stages II-III), and 90 apparently healthy volunteers of similar age group. Neutrophilic granulocytes were isolated from peripheral blood by means of double-density Ficoll-Urografin gradient.Venous blood was collected in patients into vacutainers with heparin upon admission to the hospital, before the surgery was performed. Spontaneous cytokine production (IL-8, IFNá) was determined by enzyme-linked immunosorbent assay using Vector-Best diagnostic kits. To assess phagocytic activity of neutrophilic granulocytes, the phagocytic index (according to Hamburger), number of phagocytes (according to Wright) and the index of completed phagocytosis (according to Rudik, 2006) were calculated. Immunophenotyping of neutrophilic granulocytes was carried out using an FC500 flow cytometer (Beckman Coulter, USA) with monoclonal antibodies to CD11b+, CD16+, CD95+. The results were statistically analyzed using the Statistica v.12.0 software (StatSoft Inc., USA). To assess intergroup differences, the nonparametric Kruskal-Wallis tests (for three or more comparison groups) and Mann-Whitney tests (for pairwise comparison) were used. Comparison of groups for a qualitative binary trait was carried out using the two-sided Fisher’s exact test. Data are presented as Median (25 quartile-75 quartile).The study of the functional activity of peripheral blood neutrophiles in obstructive jaundice patients caused by cholangiocarcinoma revealed an increase in their relative and absolute number, increased phagocytic index and decreased phagocytic number of neutrophilic granulocytes, increased expression of CD11b+, CD16+, CD95+ immunological markers. The changes in neutrophil secretory activity were characterized by a decrease in cytokine production (IL-2, IFNá). An increase in functional activity of neutrophilic granulocytes, along with a decrease in their cytokine production suggests that, in obstructive jaundice observed in cholangiocarcinoma at clinical stage T2-3N0-1M0, an equilibrium stage is revealed between the cells of immune system and malignant tumor.

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Duodenal diverticulum: incidental finding with potentially dangerous outcomes

Cited by 10 publications

References 1 publication

Giant duodenal diverticulum—an incidental finding

Giant duodenal diverticulum—an incidental finding

Bile Salt Enterolith: An Unusual Etiology Mimicking Gallstone Ileus

Characteristics of neutrophilic granulocytes of peripheral blood in patients with mechanical jaundice caused by cholangiocarcinoma

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