Project description:Background/aimsThere is limited knowledge regarding the management of duodenal subepithelial lesions (SELs) owing to a lack of understanding of their natural course. This study aimed to assess the natural course of asymptomatic duodenal SELs and provide management recommendations.MethodsPatients diagnosed with duodenal SELs and followed up for a minimum of 6 months were retrospectively investigated.ResultsAmong the 443,533 patients who underwent esophagogastroduodenoscopy between 2008 and 2020, duodenal SELs were identified in 0.39% (1,713 patients). Among them, 396 duodenal SELs were monitored for a median period of 72.5 months (interquartile range, 37.7-111.3 mo). Of them, 16 SELs (4.0%) showed substantial changes in size or morphology at a median follow-up of 35.1 months (interquartile range, 21.7-51.4 mo). Of these SELs with substantial changes, tissues of two SELs were acquired using endoscopic ultrasound-guided fine needle aspiration biopsy: one was a lipoma and the other was non-diagnostic. Three SELs were surgically or endoscopically removed; two were diagnosed as gastrointestinal stromal tumors, and one was a lipoma. An initial size of 20 mm or larger was associated with substantial changes during follow-up (p = 0.016).ConclusionWhile the majority of duodenal SELs may not exhibit substantial interval changes, regular follow-up with endoscopy may be necessary for cases with an initial size of 20 mm or larger, considering a possibility of malignancy.

| S-EPMC11236810 | biostudies-literature

Duodenal subepithelial neuroendocrine tumor removed by endoscopic submucosal dissection using internal traction with magnets.

Project description:Video 1Endoscopic submucosal dissection of a duodenal subepithelial neuroendocrine tumor using internal traction with magnets.

| S-EPMC9263875 | biostudies-literature

A new connection: management of disconnected segments 5 and 6 bile leak via the cystic duct remnant

Project description:Video Video 1 Management of disconnected segments 5 and 6 bile leaks.

| S-EPMC10020378 | biostudies-literature

Nonampullary duodenal subepithelial neuroendocrine tumor removed R0 by endoscopic submucosal dissection with double clips and rubber band traction.

Project description: Not available

| S-EPMC6890963 | biostudies-literature

Endoscopic resection for non-ampullary duodenal subepithelial lesions: a retrospective cohort study.

Project description:This study aimed to assess the safety and efficacy of endoscopic submucosal dissection (ESD) and pre-cutting endoscopic mucosal resection (pEMR) in treating non-ampullary duodenal subepithelial lesions (NADSELs) and to evaluate the clinical utility of endoscopic ultrasound (EUS) before endoscopic resection (ER). In this retrospective single-centre cohort study, we compared the clinical outcomes of patients with NADSELs who underwent ESD or pEMR between January 2014 and June 2023. The accuracies of EUS in determining the pathological type and origin of the lesions were evaluated using postoperative histopathology as the gold standard. Overall, 56 patients with NADSELs underwent ER in this study, including 16 and 40 treated with pEMR and ESD, respectively. There were no significant differences between the two groups in terms of en bloc resection rate, complete (R0) resection rate, perioperative complication rate, and postoperative hospital length of stay (P > 0.05). However, the pEMR group had significantly shorter median operational (13.0 min vs. 30.5 min, P < 0.001) and mean fasting (1.9 days vs. 2.8 days, P = 0.006) time and lower median hospital costs (¥12,388 vs. ¥19,579, P = 0.002). The accuracies of EUS in determining the pathological type and origin of the lesions were 76.8% and 94.6%, respectively, compared with histopathological evaluation. EUS can accurately predict the origin of NADSELs. Suitable lesions determined to originate from the submucosa or more superficial layers using EUS can be treated using pEMR as it shortens the operational and recovery time, reduces hospitalisation costs, and achieves an R0 resection rate similar to ESD.

| S-EPMC11291567 | biostudies-literature

Ruptured pancreaticoduodenal artery aneurysm presenting with duodenal obstruction.

Project description:Visceral aneurysms of the pancreaticoduodenal arcades are rare. Although these aneurysms are often asymptomatic and identified incidentally on cross-sectional imaging, aneurysm rupture presents significant morbidity. Ruptured pancreaticoduodenal arcade aneurysms typically present with abdominal pain, hemorrhagic shock, or gastrointestinal bleeding. A 72-year-old male presented with nausea and vomiting and was found to have imaging evidence of duodenal obstruction. This was due to a duodenal intramural hematoma caused by a ruptured submucosal aneurysm supplied by a branch of the inferior pancreaticoduodenal artery in the presence of median arcuate ligament compression of the celiac artery. This was subsequently treated with endovascular embolization with clinical improvement in duodenal obstruction. This case illustrates an unusual presentation of a ruptured pancreaticoduodenal arcade aneurysm.

| S-EPMC6406046 | biostudies-literature

High prevalence of proposed Mullerian duct remnant cysts on the spermatic duct in wild Eurasian otters (Lutra lutra) from Sweden.

Project description:The spermatic ducts (vasa deferentia) of 235 otters (Lutra lutra) found dead between 1999 and 2012 in Sweden were examined for presence of paraductular cysts. Single or multiple elongated uni- or bilateral cysts parallel to the spermatic duct were noted in 72% of the examined males. The cysts were adjacent to, but did not communicate with the lumen of the spermatic duct, and were usually located within a few centimeters of the testis and epididymis. The cysts are proposed to be congenital Müllerian duct remnants. Other morphologic abnormalities in the reproductive organs were not noted within this study. Possible causes of the incomplete regression of the embryonic female gonadal duct are exposure to environmental contaminants such as elevated concentrations of estrogen-like compounds (endocrine disrupting chemicals), inbreeding, or a naturally occurring anatomic defect. No obvious geographical pattern was observed for otters with or without cysts. This is the first study and description of cysts on the spermatic duct in otters.

| S-EPMC3871573 | biostudies-literature

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