摘要:

Variation in the normal duodenal papilla is common. The gross endoscopic appearances are usually not related to the frequent variations in the manner of confluence of the biliary and pancreatic ducts in the sphincter of Oddi. Malformation of the papilla of Vater is however rare. We describe 2 cases of duplication with separated biliary and pancreatic orifices. Incompetence of the biliary orifice and duodenobiliary reflux was associated in one case with recurring cholangitis. Embryology provides an explanation for this rare malformation, as the hepatopancreatic duct acquires temporarily two separate openings in the coalescing vacuoles of the duodenum during its formation. This malformation must be distinguished from acquired choledochoduodenal fistula. Its clinical significance is related to the presence or absence of duodenobiliary reflux.

ISSN:0253-4886    

DOI:10.1159/000171899

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Paraduodenal hernias occur uncommonly and produce symptoms only rarely. We describe a patient who developed mechanical small bowel obstruction 4 days after the excision of an acutely inflamed appendix. At laparotomy an obstructed left paraduodenal hernia was found to be the cause. No bowel resection was necessary, the hernia was reduced and the defect obliterated. The patient did very well postoperatively. A comprehensive review of the literature is also presented with particular reference to aetiology, diagnosis and the treatment of the left paraduodenal hernias.

ISSN:0253-4886    

DOI:10.1159/000171900

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Bleeding from the small intestine is still a very difficult diagnostic problem, even with the most advanced diagnostic procedures. This report suggests the use of intraoperative endoscopy of the small intestine by the introduction of a colonoscope through the mouth. The whole length of the small intestine can be invaginated on the advancing colonoscope and even intramural lesions can be identified and treated accordingly.

ISSN:0253-4886    

DOI:10.1159/000171901

出版商:S. Karger AG    

年代:1989

数据来源: Karger

ISSN:0253-4886    

DOI:10.1159/000171902

出版商:S. Karger AG    

年代:1989

数据来源: Karger