Gastric outlet obstruction secondary to duodenal adenoma S/P laparoscopic pancreaticoduodenectomy / Carl Evans Y. De Castro ; Raymund Andrew G. Ong and Jenine Joy C. Segismundo.

Contributor(s):

Language: english Publication details: Fairview, Quezon City: Department of Surgery, FEU-NRMF, 2020Description: photos; (in folder) with flash drive (soft copy)Content type:

text

Media type:

unmediated

Carrier type:

volume

LOC classification:

SUR 2020 0003

Summary: Abstract: Adenomas are the most common benign tumor found in the small intestine and are most frequently seen at duodemun. However, they are rare having an incidence rate as low as 0.03%. Duodenal adenomas are usually asymptomatic and only diagnosed as incidental finding during esophagogastroduodenoscopy. In this case study, a 39 year old male presented with intermittent symptomatology of gastric outlet obstruction and has consulted to different medical institutions for a span of 5 months. Several diagnostic workup was done on his admission in our institution, which includes whole abdominal CT scan with contrast, esophagogastroduodenoscopy with biopsy and endoscopic ultrasound with biopsy which all showed gross findings of circumferential mass at the gastric pylorus extending to the first part of the duodenum with luminal narrowing of >90%, suspicious for malignancy and histological findings of adenoma with mild dysplasia. Surgical treatment is recommended in cases of duodenal adenoma larger than 2 cm and in cases with the presence of severe dysplasia and suspicious carcinomatous infiltration. Four major surgical procedures were contemplated for the removal of the duodenal adenoma which includes pancreas preserving duodenectomy, transduodenal excision, local full-thickness resection, and pancreaticoduodenectomy. Final surgical procedure done was laparoscopic pancreaticoduodenectomy due to >3 cm size, location of mass and high chance of malignancy of its highly effective surgical procedure it has been reported to have life-threatening complications associated with perioperative morbidity requiring intensive care management, mortality, and long-term effect on patients' quality of life. Therefore, endoscopic resection of duodenal adenomas has been introduced as a less invasive effective alternative, but has limited to small and superficial adenomas. In this case study, pancreas preserving duodenectomy as a safer surgical approach to symptomatic large duodenal adenoma will be discussed.

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Holdings
Item type	Current library	Call number	Status	Notes	Date due	Barcode
Room Use	Far Eastern University - Nicanor Reyes Medical Foundation Research	SUR 2020 0003 (Browse shelf(Opens below))	Available	with flash drive (soft copy)		R000997

Includes bibliographical references.

Abstract: Adenomas are the most common benign tumor found in the small intestine and are most frequently seen at duodemun. However, they are rare having an incidence rate as low as 0.03%. Duodenal adenomas are usually asymptomatic and only diagnosed as incidental finding during esophagogastroduodenoscopy. In this case study, a 39 year old male presented with intermittent symptomatology of gastric outlet obstruction and has consulted to different medical institutions for a span of 5 months. Several diagnostic workup was done on his admission in our institution, which includes whole abdominal CT scan with contrast, esophagogastroduodenoscopy with biopsy and endoscopic ultrasound with biopsy which all showed gross findings of circumferential mass at the gastric pylorus extending to the first part of the duodenum with luminal narrowing of >90%, suspicious for malignancy and histological findings of adenoma with mild dysplasia. Surgical treatment is recommended in cases of duodenal adenoma larger than 2 cm and in cases with the presence of severe dysplasia and suspicious carcinomatous infiltration. Four major surgical procedures were contemplated for the removal of the duodenal adenoma which includes pancreas preserving duodenectomy, transduodenal excision, local full-thickness resection, and pancreaticoduodenectomy. Final surgical procedure done was laparoscopic pancreaticoduodenectomy due to >3 cm size, location of mass and high chance of malignancy of its highly effective surgical procedure it has been reported to have life-threatening complications associated with perioperative morbidity requiring intensive care management, mortality, and long-term effect on patients' quality of life. Therefore, endoscopic resection of duodenal adenomas has been introduced as a less invasive effective alternative, but has limited to small and superficial adenomas. In this case study, pancreas preserving duodenectomy as a safer surgical approach to symptomatic large duodenal adenoma will be discussed.

Research - Department of Surgery

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