Jadlowiec Caroline C, Lobel Beata E, Akolkar Namita, Bourque Michael D, Devers Thomas J, McFadden David W
University of Connecticut General Surgery Residency Program, Farmington, CT 06030, USA.
University of Connecticut General Surgery Residency Program, Farmington, CT 06030, USA; Connecticut Children's Medical Center, Department of Pediatric Surgery, Hartford, CT 06106, USA.
Case Rep Surg. 2015;2015:659150. doi: 10.1155/2015/659150. Epub 2015 Dec 30.
Duodenal duplications in adults are exceedingly rare and their diagnosis remains difficult as symptoms are largely nonspecific. Clinical presentations include pancreatitis, biliary obstruction, gastrointestinal bleeding from ectopic gastric mucosa, and malignancy. A case of duodenal duplication in a 59-year-old female is presented, and her treatment course is reviewed with description of combined surgical and endoscopic approach to repair, along with a review of historic and current recommendations for management. Traditionally, gastrointestinal duplications have been treated with surgical resection; however, for duodenal duplications, the anatomic proximity to the biliopancreatic ampulla makes surgical management challenging. Recently, advances in endoscopy have improved the clinical success of cystic intraluminal duodenal duplications. Despite these advances, surgical resection is still recommended for extraluminal tubular duplications although combined techniques may be necessary for long tubular duplications. For duodenal duplications, a combined approach of partial excision combined with mucosal stripping may offer advantage.
成人十二指肠重复畸形极为罕见，由于症状大多不具特异性，其诊断仍然困难。临床表现包括胰腺炎、胆管梗阻、异位胃黏膜引起的胃肠道出血以及恶性肿瘤。本文介绍了一例59岁女性十二指肠重复畸形病例，并回顾了其治疗过程，描述了手术和内镜联合修复方法，同时回顾了过去和当前的治疗建议。传统上，胃肠道重复畸形采用手术切除治疗；然而，对于十二指肠重复畸形，由于其与胆胰壶腹在解剖位置上接近，手术治疗具有挑战性。近年来，内镜技术的进步提高了囊性腔内十二指肠重复畸形的临床治疗成功率。尽管有这些进展，但对于腔外管状重复畸形仍建议手术切除，尽管对于长管状重复畸形可能需要联合技术。对于十二指肠重复畸形，部分切除联合黏膜剥脱的联合方法可能具有优势。
