Case Report
PDF EndNote BibTex Cite

Pankreatik kitle gibi görünen benign bir lezyon; duodenal divertikül: Olgu Sunumu

Year 2019, Volume 33, Issue 3, 267 - 270, 06.02.2020
https://doi.org/10.5505/deutfd.2019.68815

Abstract

Bu çalışmamızda, kliniğimize dış merkezden pankreatik kitle ön tanısıyla yönlendirilen, yapılan ileri tetkik ve değerlendirmeler sonucunda duodenal divertikül tanısı konulan bir hastayı sunmayı amaçladık. 59 yaşında erkek hastaya dış merkezde pankreas kitlesi tanısı konulduğu ve cerrahi rezeksiyon önerilerek hastanemize sevk edildiği öğrenildi. Hastanın ana yakınması epigastrik ağrıydı. Fizik muayenesi normaldi. Tam kan sayımı, biyokimyasal parametreler ve tümör belirteçleri normaldi. İlk merkezde yapılan görüntülemede kistik bir pankreatik kitleden bahsedilmekteydi. Hastaya çekilen oral ve intravenöz kontrastlı bilgisayarlı tomografide mide fundusunda 6 cm'lik gastrik divertikül izlendi. Ek olarak, duodenumun ikinci bölümünde çoklu divertiküller görüldü. Ortak safra kanalı ve ana pankreas kanalının dilate olduğu görüldü. Endoskopide, fundusta geniş bir divertikül orifisi görüldü. Buna ek olarak, başka bir papilla Vater tespit edildi. Endoskopik ultrason, divertikül tanısını doğruladı. Ortak safra kanalı ve pankreas kanalının da dilate olduğu bulundu (sırasıyla 12 mm ve 8,9 mm). Hasta bulgular hakkında bilgilendirildi ve ek bir tedavi yapılmadan taburcu edildi. Sonuç olarak, duodenal divertikül, nadiren pankreas neoplazmlarıyla karıştırıldığı bildirilen bir durumdur. Ayırıcı tanıda akılda tutulması gerekir

References

  • 1. Huang R, Romano A, Stone M, Nathanson N. Diagnosis and treatment of a perforated duodenal diverticulum. Emerg Radiol 2007;13:285-7.
  • 2. Scott L Friedman, Keneth R.Mc Guard, Jones H. Grandel: Current Diagnosis and Tretment in Gastroenterology 2003 page:403.
  • 3. Deodato G, Consoli A, Saggio A, Impellizzeri T, Bondi M, Cultrera P: Gastric diverticula. Chir aİtal1976.
  • 4. Marra B: Stomach diverticulum. A case report. Minerva Chir. 1993 Apr 15;48(7):355-7.
  • 5. Mahajan KS, et al. Doudenal diverticulum: review of literature. Indian J Surg.2004;66:140 5.
  • 6. Rodeberg DA, Zaheer S, Moir CR, Ishitani MB. Gastric diverticulum:a series of four pediatric patients. J Pediatr Gastroenterol Nutr 2002; 34: 564-567 [PMID: 12050587 DOI: 10.1097/01. MPG.0000014963.68729.15].
  • 7. Afridi SA, Fichenbaum CJ, Taubin H. Review of duodenal diverticula. Am J Gastroenterology 1991;86:935-8.
  • 8. Sakurai Y, Miura H, Matsubara T, et al. Perforated duodenal diverticulum successfully diagnosed preoperatively with abdominal CT scan associated with upper gastrointestinal series. J Gastroenterol 2004;39:379-83.
  • 9. Cavanagh JE Jr. Iatrogenic perforation of perivaterion duodenal diverticulum: Report of a case. Can J Surg 1996;39:336-8.
  • 10. Uoma G, Manes G, Ragozzino A, et al. Periampullary extraluminal duodenal diverticula and acute pancreatitis: An underestimated etiological association. Am J Gastroenterol 1996;91:1186-8.
  • 11. Hariri A, Siegelman SS, Hruban RH. Duodenal diverticulum mimicking a cystic pancreatic neoplasm. Br J Radiol 2005;78:562-4.
  • 12. Mallappa S, Jiao LR. Jukstapapillary duodenal diverticulum masquera dingas as a cystic pancreatic neoplasm. JRSM Short Rep 2011;2:89.

A BENIGN LESION THAT APPEARS TO BE A PANCREATIC MASS; DUODENAL DIVERTICULUM, CASE REPORT

Year 2019, Volume 33, Issue 3, 267 - 270, 06.02.2020
https://doi.org/10.5505/deutfd.2019.68815

Abstract

We here in present a patient who was referred to our clinic from another center with a diagnosis of pancreatic mass. Detailed evaluation in our clinic revealed a final diagnosis of doudenal diverticula. A 59-year-old male patient was diagnosed as pancreatic mass in another center. Surgical resection was recommended and the patient was referred to our hospital. The main complaint of the patient was epigastric pain. The physical examination was normal. Complete blood count, biochemical parameters, and tumor markers were found to be normal. The imaging performed at the initial center showed a cystic pancreatic mass. Oral and intravenous contrast-enhanced computed tomography revealed a 6-cm gastric diverticula in the fundus. In addition, multiple diverticula was seen in the second portion of the duodenum. Common bile duct and the main pancreatic duct were found to be dilated. On endoscopy, a wide orifice of diverticula was seen in the fundus. In addition, another the papilla of Vater was observed. Endoscopic ultrasound confirmed the diverticula. Common bile duct and pancreatic duct was was also found to be dilated (12 mm and 8.9 mm, respectively). The patient was informed about the findings and was discharged without any additional-treatment. Duodenal diverticulum is a rare condition, which have been rarely reported to be confused with pancreatic neoplasms. It should be kept in mind in the differential diagnosis.

References

  • 1. Huang R, Romano A, Stone M, Nathanson N. Diagnosis and treatment of a perforated duodenal diverticulum. Emerg Radiol 2007;13:285-7.
  • 2. Scott L Friedman, Keneth R.Mc Guard, Jones H. Grandel: Current Diagnosis and Tretment in Gastroenterology 2003 page:403.
  • 3. Deodato G, Consoli A, Saggio A, Impellizzeri T, Bondi M, Cultrera P: Gastric diverticula. Chir aİtal1976.
  • 4. Marra B: Stomach diverticulum. A case report. Minerva Chir. 1993 Apr 15;48(7):355-7.
  • 5. Mahajan KS, et al. Doudenal diverticulum: review of literature. Indian J Surg.2004;66:140 5.
  • 6. Rodeberg DA, Zaheer S, Moir CR, Ishitani MB. Gastric diverticulum:a series of four pediatric patients. J Pediatr Gastroenterol Nutr 2002; 34: 564-567 [PMID: 12050587 DOI: 10.1097/01. MPG.0000014963.68729.15].
  • 7. Afridi SA, Fichenbaum CJ, Taubin H. Review of duodenal diverticula. Am J Gastroenterology 1991;86:935-8.
  • 8. Sakurai Y, Miura H, Matsubara T, et al. Perforated duodenal diverticulum successfully diagnosed preoperatively with abdominal CT scan associated with upper gastrointestinal series. J Gastroenterol 2004;39:379-83.
  • 9. Cavanagh JE Jr. Iatrogenic perforation of perivaterion duodenal diverticulum: Report of a case. Can J Surg 1996;39:336-8.
  • 10. Uoma G, Manes G, Ragozzino A, et al. Periampullary extraluminal duodenal diverticula and acute pancreatitis: An underestimated etiological association. Am J Gastroenterol 1996;91:1186-8.
  • 11. Hariri A, Siegelman SS, Hruban RH. Duodenal diverticulum mimicking a cystic pancreatic neoplasm. Br J Radiol 2005;78:562-4.
  • 12. Mallappa S, Jiao LR. Jukstapapillary duodenal diverticulum masquera dingas as a cystic pancreatic neoplasm. JRSM Short Rep 2011;2:89.

Details

Primary Language Turkish
Subjects Medicine
Journal Section Case Studies
Authors

Mustafa SALIŞ This is me (Primary Author)
ESKİŞEHİR OSMANGAZİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, GENEL CERRAHİ ANABİLİM DALI
0000-0002-3085-0087
Türkiye


Arda YILMAZ This is me
ESKİŞEHİR OSMANGAZİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, GENEL CERRAHİ ANABİLİM DALI
0000-0003-1269-0814
Türkiye

Publication Date February 6, 2020
Application Date July 28, 2019
Acceptance Date October 12, 2019
Published in Issue Year 2019, Volume 33, Issue 3

Cite

Vancouver Salış M. , Yılmaz A. Pankreatik kitle gibi görünen benign bir lezyon; duodenal divertikül: Olgu Sunumu. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi. 2020; 33(3): 267-270.