Arteriomesenteric duodenal occlusion associated with strongyloidiasis

Arteriomesenteric occlusion of the distal duodenum may occur in clinical conditions which result in narrowing of the angle between the aorta and superior mesenteric artery. Two patients with arteriomesenteric duodenal occlusion associated with Strongyloides stercoralis infection are described. In one patient the mechanism of occlusion appeared to be significant weight loss and associated visceroptosis, while in the other patient increased diameter of superior mesenteric vessels was the major factor. Strongyloidiasis, a curable parasitic infection, should be considered in patients presenting with arteriomesenteric occlusion of the distal duodenum. (AU)

Highly selective vagotomy and digital dilatation for stenosing duodenal ulcer - abstract

Twenty-eight patients (24 males and 4 females) with pyloroduodenal obstruction due to chronic duodenal ulcer had highly selective vagotomy (HSV) alone (6/28) or HSV and digital dilatation (DD) of stenosis (22/28), 1 to 4 years previously. Their ages ranged from 19 to 61 years, with a mean of 42 years. There was no post-operative death. One patient had perforation of the duodenum during dilatation. The only patient with Hb SS disease, a male aged 49, died from haemorrhage and perforation of recurrent ulcer 1 year after surgery. Two other males had easily controllable recurrent duodenal ulcers, but no stenosis. Another male died of unrelated cause after two symptom-free years. Six males were re-operated on for symptoms of gastric stasis. Only 3 of these were found to have complete fibrous stenosis for which gastro-enterostomy was done. The other three had adequate pyloroduodenal lumen. Patients with inflammatory stenosis do well after HSV and DD, but this combined procedure should be avoided in fibrous tissue stenosis (AU)

Arteriomesenteric duodenal compression following head injury

A patient who lost 15 kg in weight while recovering from severe brain injury stated vomiting after 7 weeks. Barium meal confirmed vascular compression of the duodenum as the cause of his vomiting. Vomiting persisted in spite of high calorie liquid feeds and hyperalimentation. Duodenojejunostomy, performed 4 weeks later, cured his vomiting occurs in the severely brain-injured patient with weight loss, and indeed in any patient with prolonged recumbency and weight loss (AU)

Congenital duodenal stenosis in an adult presenting with severe electrolyte imbalance

This case report studies congenital duodenal stenosis, which is rare, particularly when it presents in adults. This report is of such a patient, who on investigation had some features suggestive of the Zollinger-Ellison syndrome. The diagnosis of Zollinger-Ellison syndrome was entertained on the basis of the gastric acid studies and the radiological features of coarse mucosal folds in the stomach and the disordered small-bowel mucosal pattern, although the clinical features were atypical