Recurrent acute pancreatitis in bowel malrotation.

G. Alessandri1
Estimated H-index: 1
(Manchester Royal Infirmary),
A Amodio1
Estimated H-index: 1
+ 2 AuthorsClaudio Bassi110
Estimated H-index: 110
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Abstract
Recurrent acute pancreatitis is an uncommon diagnosis in teenagers. Excluded alcohol and biliary stones, more prevalent aetiologies in these group of patients are genetic pancreatitis, pancreatic duct system abnormalities, neoplasia, traumas and congenital abnormalities of the duodenum such as duodenal duplication or diverticulum. Two reported cases of recurrent pancreatitis associated to midgut malrotation were described in English literature. Bowel malrotation is a difficult diagnosis in a teenager or a young adult and a common delay is documented. Ladd's procedure is largely recognized to be the standard treatment for a symptomatic malrotation.Our Report describes in details a case of recurrent pancreatitis, where a late diagnosis of midgut malrotation was obtained and an endoscopic management was attempted. A literature review and an analysis of two previously reported cases were performed to explore a possible aetiopathogenesis of the recurrent acute pancreatitis in patients with midgut malrotation.24 months of follow-up showed an asymptomatic patient on a free diet, with a mild deranged Liver Functional Tests and a normal Amylase and Lipase. The recurrence of acute pancreatitis has not been observed until the present day.Recurrent episodes of acute pancreatitis in young adults, without a history of alcohol abuse or evidence of gallstones, might be an atypical presentation of midgut malrotation and it should be in the differential diagnosis. In this case, a Ladd's operation is beneficial and an endoscopic procedure does not obtain advantages.
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#2Christina Avgoustou (UoA: National and Kapodistrian University of Athens)H-Index: 3
A 70-year old man with severe comorbidities, hemodynamically stable, was emergently admitted for bowel obstruction. His chronic intractable constipation had never been evaluated. The patient had no history of abdominal surgery. Computed tomography indicated a large obstructive rectosigmoid tumour and dolichocolon. Immediate rectoscopy confirmed the presence of the obstructive tumour. Additionally, on emergent laparotomy, a malformed right-sided duodenum with right-sided small bowel and other mid...
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#1Ziman Xiong (HUST: Huazhong University of Science and Technology)H-Index: 1
#2Yaqi Shen (HUST: Huazhong University of Science and Technology)H-Index: 9
Last. Daoyu Hu (HUST: Huazhong University of Science and Technology)H-Index: 16
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OBJECTIVE To classify adult intestinal malrotation by CT. METHODS This retrospective study enrolled adults diagnosed with intestinal malrotation who underwent abdominal CT at our institution between June 1, 2013, and August 30, 2020. All patients' clinical information was recorded. Patients were divided into groups undergoing surgical and conservative management. The duodenum (nonrotation, partial rotation, and malrotation), jejunum, cecum, and the superior mesenteric artery/superior mesenteric ...
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#1Jonathan J. Neville (NWU: North-West University)H-Index: 1
#2Jack Gallagher (NWU: North-West University)H-Index: 1
Last. Hemant Sheth (NWU: North-West University)H-Index: 2
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Adult midgut malrotation is a rare cause of an acute abdomen requiring urgent intervention. It may also present in the non-acute setting with chronic, non-specific symptoms. The objective of this study is to identify the clinical features, appropriate investigations and current surgical management associated with adult malrotation. A systematic review was conducted according to PRISMA guidelines, identifying confirmed cases of adult malrotation. Patient demographics, clinical features, investiga...
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Aim-Background Acute presentation in adulthood of the indolent developmental midgut malformations constitutes a diagnostic problem and emergent surgery may result to an operative surprise.
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