Management of Perforation of the Third and Fourth Part of the Duodenum; A Review Article
Main Article Content
Keywords
Growth, second, scan
Abstract
A perforation or as called; diverticulum in the duodenum is the second most common location for one in the digestive system. Less than 200 occurrences of perforation were reported, therefore problems are quite uncommon. As many as 22 percent of the population may have discomfort from duodenal diverticula, which were originally identified in 1710. Bleeding, inflammation, compression of surrounding organs, growth of malignancy, cholestasis, and holes in the organ are all possible but extremely rare consequences. Due to the perforation's location in the abdomen, peritoneal irritation is a symptom that may or may not present itself. As a result, a clinical diagnosis is more challenging for the treating physician. Extra-luminal retroperitoneal air and mesenteric fat stranding can be seen on a CT scan, which can assist diagnose the problem. Although non-surgical treatments have had success with some patients, surgery remains the gold standard. Duodenopancreatectomy and diverticulitis surgery are two other alternatives for management of third and forth parts of duodenal perforations. Rare as they may be, perforated diverticula in the duodenal segment IV nevertheless respond favourably to surgical intervention. If you or someone you know sustains an abdominal injury, your first instinct should be to suspect foul play. Ideally, you would get a CT scan. Treatment options must take into account the patient's current health status and any other medical conditions they may have, as well as the surgeon's level of experience, any applicable recommendations, and any accessible resources.
References
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another two successful cases. Case Reports in Surgery, 2017.
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Surgery, 189(5), 627.
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small bowel perforations: the pivotal role of physical investigation. Canadian Journal of Surgery, 55(2), 99.
18. García-Molina, F. J., Mateo-Vallejo, F., de Dios Franco-Osorio, J., Esteban-Ramos, J. L., & Rivero-Henández, I. (2015). Surgical approach for
tumours of the third and fourth part of the duodenum. Distal pancreas-sparing duodenectomy. International Journal of Surgery, 18, 143-148.
19. Hill, A. G. (2001). Management of perforated duodenal ulcer. In Surgical Treatment: EvidenceBased and Problem-Oriented. Zuckschwerdt.
20. Howard, T. J., Tan, T., Lehman, G. A., Sherman, S., Madura, J. A., Fogel, E., ... & Kopecky, K. K. (1999). Classification and management of
perforations complicating endoscopic sphincterotomy. Surgery, 126(4), 658-665.
21. Inoue, T., Uedo, N., Yamashina, T., Yamamoto, S., Hanaoka, N., Takeuchi, Y., ... & Ohigashi, H. (2014). Delayed perforation: a hazardous
complication of endoscopic resection for non‐ampullary duodenal neoplasm. Digestive endoscopy, 26(2), 220-227.
22. Juler, G. L., List, J. W., Stemmer, E. A., & Connolly, J. E. (1969). Perforating duodenal diverticulitis. Archives of Surgery, 99(5), 572-578.
23. Kapp, J. R., Müller, P. C., Gertsch, P., Gubler, C., Clavien, P. A., & Lehmann, K. (2022). A systematic review of the perforated duodenal
diverticula: lessons learned from the last decade. Langenbeck's Archives of Surgery, 407(1), 25-35.
24. Kumbhari, V., Sinha, A., Reddy, A., Afghani, E., Cotsalas, D., Patel, Y. A., ... & Singh, V. K. (2016). Algorithm for the management of ERCPrelated perforations. Gastrointestinal endoscopy, 83(5), 934-943.
25. Markogiannakis, H., Theodorou, D., Toutouzas, K. G., Gloustianou, G., Katsaragakis, S., & Bramis, I. (2008). Adenocarcinoma of the third and fourth portion of the duodenum: a case report and review of the literature. Cases journal, 1(1), 1-4.
26. McCreery, J. A. (1924). Acute perforated ulcer of the stomach and duodenum. Annals of Surgery, 79(1), 91.
27. Nepal, P., Maemura, K., Mataki, Y., Kurahara, H., Kawasaki, Y., Hiwatashi, K., ... & Natsugoe, S. (2017). Management of horizontal duodenal
perforation: a report of three cases and review of literature. Surgical Case Reports, 3(1), 1-6.
28. Oukachbi, N., & Brouzes, S. (2013). Management of complicated duodenal diverticula. Journal of visceral surgery, 150(3), 173-179.
29. Rajagopalan, A. E., & Pickleman, J. (1982). Free perforation of the small intestine. Annals of surgery, 196(5), 576.
30. Schnueriger, B., Vorburger, S. A., Banz, V. M., Schoepfer, A. M., & Candinas, D. (2008). Diagnosis and management of the symptomatic
duodenal diverticulum: a case series and a short review of the literature. Journal of gastrointestinal surgery, 12(9), 1571-1576.
31. Shilyansky, J., Pearl, R. H., Kreller, M., Sena, L. M., & Babyn, P. S. (1997). Diagnosis and management of duodenal injuries in children.
Journal of pediatric surgery, 32(6), 880-886.
32. Shimada, A., Fujita, K., Kitago, M., Ichisaka, S., Ishikawa, K., Kikunaga, H., ... & Miura, H. (2020). Perforated duodenal diverticulum successfully treated with a combination of surgical drainage and endoscopic nasobiliary and nasopancreatic drainage: a case report. Surgical case reports, 6(1), 1-6.
33. Simões, V. C., Santos, B., Magalhães, S., Faria, G., Silva, D. S., & Davide, J. (2014). Perforated duodenal diverticulum: Surgical treatment and
literature review. International journal of surgery case reports, 5(8), 547-550.
34. Snyder, W. H., Weigelt, J. A., Watkins, W. L., & Bietz, D. S. (1980). The surgical management of duodenal trauma: precepts based on a review of 247 cases. Archives of Surgery, 115(4), 422-429.
35. STONE, H. H., & FABIAN, T. C. (1979). Management of duodenal wounds. Journal of Trauma and Acute Care Surgery, 19(5), 334-339.
36. Strong, E. K. (1958). Mechanics of arteriomesenteric duodenal obstruction and direct surgical attack upon etiology. Annals of surgery,
148(5), 725.
37. Thompson, N. W., Pasieka, J., & Fukuuchi, A. (1993). Duodenal gastrinomas, duodenotomy, and duodenal exploration in the surgical management of Zollinger-Ellison syndrome. World journal of surgery, 17(4), 455-462.
38. Wichmann, D., Jansen, K. T., Onken, F., Stüker, D., Zerabruck, E., Werner, C. R., ... & Quante, M. (2021). Endoscopic negative pressure therapy as stand-alone treatment for perforated duodenal diverticulum: presentation of two cases. BMC gastroenterology, 21(1), 1-6.
39. Wong, C. S., Chia, C. F., Lee, H. C., Wei, P. L., Ma, H. P., Tsai, S. H., ... & Tam, K. W. (2013). Eradication of Helicobacter pylori for prevention
of ulcer recurrence after simple closure of perforated peptic ulcer: a meta-analysis of randomized controlled trials. Journal of surgical
research, 182(2), 219-226.
40. Yamamoto, Y., Yoshizawa, N., Tomida, H., Fujisaki, J., & Igarashi, M. (2014). Therapeutic outcomes of endoscopic resection for superficial
non‐ampullary duodenal tumor. Digestive Endoscopy, 26, 50-56.
41. Yildirim, S., Culhaoglu, A. B., & Ozdemir, N. (1995). Carcinoma of the fourth part of the duodenum: report of a case. Surgery Today,
25(12), 1034-1037.
42. Biswas, S. ., Bhagyasree, V. ., & Rathod, V. N. . (2022). A CHECKLIST OF BIRDS AND DIVERSITY OF AVIAN FAUNA IN MUDASARLOVA RESERVOIR OF VISAKHAPATNAM, INDIA . Journal Of Advanced Zoology, 42(02), 165–175. https://doi.org/10.17762/jaz.v42i02.51
43. Faisal, H. T. ., Abid, M. K. ., & Abed, A. . (2022). Study Of Some Biochemical Parameters in Dose During Pregnancy in Goats. Journal Of Advanced Zoology, 43(1), 01–06. https://doi.org/10.17762/jaz.v43i1.109
44. Wankhade, L. N. . (2022). STUDY ON BUTTERFLY FAUNA OF KARANJA (GHADGE) TAHSIL OF DISTRICT WARDHA (MAHARASHTRA). Journal Of Advanced Zoology, 42(02), 186–193. https://doi.org/10.17762/jaz.v42i02.53
40(12), 1903-1907.
2. Ames, J. T., Federle, M. P., & Pealer, K. M. (2009). Perforated duodenal diverticulum: clinical and imaging findings in eight patients. Abdominal imaging, 34(2), 135-139.
3. Ansari, D., Torén, W., Lindberg, S., Pyrhönen, H. S., & Andersson, R. (2019). Diagnosis and management of duodenal perforations: a narrative
review. Scandinavian journal of gastroenterology, 54(8), 939-944.
4. Avgerinos, D. V., Llaguna, O. H., Lo, A. Y., Voli, J., & Leitman, I. M. (2009). Management of endoscopic retrograde cholangiopancreatography:
related duodenal perforations. Surgical endoscopy, 23(4), 833-838.
5. Ballard, R. B., Badellino, M. M., Eynon, C. A., Spott, M. A., Staz, C. F., & Buckman, R. F. (1997). Blunt duodenal rupture: a 6-year statewide
experience. Journal of Trauma and Acute Care Surgery, 43(2), 229-233.
6. Barillaro, I., Grassi, V., De Sol, A., Renzi, C., Cochetti, G., Barillaro, F., ... & Noya, G. (2013). Endoscopic rendez-vous after damage control
surgery in treatment of retroperitoneal abscess from perforated duodenal diverticulum: a techinal note and literature review. World Journal of
Emergency Surgery, 8(1), 1-6.
7. Behrman, S. W. (2005). Management of complicated peptic ulcer disease. Archives of surgery, 140(2), 201-208.
8. Berne, C. J., Donovan, A. J., White, E. J., & Yellin, A. E. (1974). Duodenal “diverticulization” for duodenal and pancreatic injury. The American
Journal of Surgery, 127(5), 503-507.
9. BURRUS, G. R., Howell, J. F., & JORDAN JR, G. L. (1961). Traumatic duodenal injuries: an analysis of 86 cases. Journal of Trauma and Acute Care Surgery, 1(2), 96-104.
10. Cellan-Jones, C. J. (1929). A rapid method of treatment in perforated duodenal ulcer. British medical journal, 1(3571), 1076.
11. Dean, H. P. (1894). A Case of Perforation of a Chronic Ulcer of the Duodenum Successfully Treated by Excision: Death Two Months later
from Acute Intestinal Obstruction by a Band 1. British Medical Journal, 1(1741), 1014.
12. Degheili, J. A., Abdallah, M. H., Haydar, A. A., Moukalled, A., & Hallal, A. H. (2017). Perforated duodenal diverticulum treated conservatively:
another two successful cases. Case Reports in Surgery, 2017.
13. DeMars, J. J., Bubrick, M. P., & Hitchcock, C. R. (1979). Duodenal perforation in blunt abdominal trauma. Surgery, 86(4), 632-638.
14. Donald, J. W. (1979). Major complications of small bowel diverticula. Annals of surgery, 190(2), 183.
15. Donovan, A. J., & Hagen, W. E. (1966). Traumatic perforation of the duodenum. The American Journal of Surgery, 111(3), 341-350.
16. Donovan, A. J., Vinson, T. L., Maulsby, G. O., & Gewin, J. R. (1979). Selective treatment of duodenal ulcer with perforation. Annals of
Surgery, 189(5), 627.
17. Dubecz, A., Ottmann, J., Schweigert, M., Stadlhuber, R. J., Feith, M., Wiessner, V., ... & Stein, H. J. (2012). Management of ERCP-related
small bowel perforations: the pivotal role of physical investigation. Canadian Journal of Surgery, 55(2), 99.
18. García-Molina, F. J., Mateo-Vallejo, F., de Dios Franco-Osorio, J., Esteban-Ramos, J. L., & Rivero-Henández, I. (2015). Surgical approach for
tumours of the third and fourth part of the duodenum. Distal pancreas-sparing duodenectomy. International Journal of Surgery, 18, 143-148.
19. Hill, A. G. (2001). Management of perforated duodenal ulcer. In Surgical Treatment: EvidenceBased and Problem-Oriented. Zuckschwerdt.
20. Howard, T. J., Tan, T., Lehman, G. A., Sherman, S., Madura, J. A., Fogel, E., ... & Kopecky, K. K. (1999). Classification and management of
perforations complicating endoscopic sphincterotomy. Surgery, 126(4), 658-665.
21. Inoue, T., Uedo, N., Yamashina, T., Yamamoto, S., Hanaoka, N., Takeuchi, Y., ... & Ohigashi, H. (2014). Delayed perforation: a hazardous
complication of endoscopic resection for non‐ampullary duodenal neoplasm. Digestive endoscopy, 26(2), 220-227.
22. Juler, G. L., List, J. W., Stemmer, E. A., & Connolly, J. E. (1969). Perforating duodenal diverticulitis. Archives of Surgery, 99(5), 572-578.
23. Kapp, J. R., Müller, P. C., Gertsch, P., Gubler, C., Clavien, P. A., & Lehmann, K. (2022). A systematic review of the perforated duodenal
diverticula: lessons learned from the last decade. Langenbeck's Archives of Surgery, 407(1), 25-35.
24. Kumbhari, V., Sinha, A., Reddy, A., Afghani, E., Cotsalas, D., Patel, Y. A., ... & Singh, V. K. (2016). Algorithm for the management of ERCPrelated perforations. Gastrointestinal endoscopy, 83(5), 934-943.
25. Markogiannakis, H., Theodorou, D., Toutouzas, K. G., Gloustianou, G., Katsaragakis, S., & Bramis, I. (2008). Adenocarcinoma of the third and fourth portion of the duodenum: a case report and review of the literature. Cases journal, 1(1), 1-4.
26. McCreery, J. A. (1924). Acute perforated ulcer of the stomach and duodenum. Annals of Surgery, 79(1), 91.
27. Nepal, P., Maemura, K., Mataki, Y., Kurahara, H., Kawasaki, Y., Hiwatashi, K., ... & Natsugoe, S. (2017). Management of horizontal duodenal
perforation: a report of three cases and review of literature. Surgical Case Reports, 3(1), 1-6.
28. Oukachbi, N., & Brouzes, S. (2013). Management of complicated duodenal diverticula. Journal of visceral surgery, 150(3), 173-179.
29. Rajagopalan, A. E., & Pickleman, J. (1982). Free perforation of the small intestine. Annals of surgery, 196(5), 576.
30. Schnueriger, B., Vorburger, S. A., Banz, V. M., Schoepfer, A. M., & Candinas, D. (2008). Diagnosis and management of the symptomatic
duodenal diverticulum: a case series and a short review of the literature. Journal of gastrointestinal surgery, 12(9), 1571-1576.
31. Shilyansky, J., Pearl, R. H., Kreller, M., Sena, L. M., & Babyn, P. S. (1997). Diagnosis and management of duodenal injuries in children.
Journal of pediatric surgery, 32(6), 880-886.
32. Shimada, A., Fujita, K., Kitago, M., Ichisaka, S., Ishikawa, K., Kikunaga, H., ... & Miura, H. (2020). Perforated duodenal diverticulum successfully treated with a combination of surgical drainage and endoscopic nasobiliary and nasopancreatic drainage: a case report. Surgical case reports, 6(1), 1-6.
33. Simões, V. C., Santos, B., Magalhães, S., Faria, G., Silva, D. S., & Davide, J. (2014). Perforated duodenal diverticulum: Surgical treatment and
literature review. International journal of surgery case reports, 5(8), 547-550.
34. Snyder, W. H., Weigelt, J. A., Watkins, W. L., & Bietz, D. S. (1980). The surgical management of duodenal trauma: precepts based on a review of 247 cases. Archives of Surgery, 115(4), 422-429.
35. STONE, H. H., & FABIAN, T. C. (1979). Management of duodenal wounds. Journal of Trauma and Acute Care Surgery, 19(5), 334-339.
36. Strong, E. K. (1958). Mechanics of arteriomesenteric duodenal obstruction and direct surgical attack upon etiology. Annals of surgery,
148(5), 725.
37. Thompson, N. W., Pasieka, J., & Fukuuchi, A. (1993). Duodenal gastrinomas, duodenotomy, and duodenal exploration in the surgical management of Zollinger-Ellison syndrome. World journal of surgery, 17(4), 455-462.
38. Wichmann, D., Jansen, K. T., Onken, F., Stüker, D., Zerabruck, E., Werner, C. R., ... & Quante, M. (2021). Endoscopic negative pressure therapy as stand-alone treatment for perforated duodenal diverticulum: presentation of two cases. BMC gastroenterology, 21(1), 1-6.
39. Wong, C. S., Chia, C. F., Lee, H. C., Wei, P. L., Ma, H. P., Tsai, S. H., ... & Tam, K. W. (2013). Eradication of Helicobacter pylori for prevention
of ulcer recurrence after simple closure of perforated peptic ulcer: a meta-analysis of randomized controlled trials. Journal of surgical
research, 182(2), 219-226.
40. Yamamoto, Y., Yoshizawa, N., Tomida, H., Fujisaki, J., & Igarashi, M. (2014). Therapeutic outcomes of endoscopic resection for superficial
non‐ampullary duodenal tumor. Digestive Endoscopy, 26, 50-56.
41. Yildirim, S., Culhaoglu, A. B., & Ozdemir, N. (1995). Carcinoma of the fourth part of the duodenum: report of a case. Surgery Today,
25(12), 1034-1037.
42. Biswas, S. ., Bhagyasree, V. ., & Rathod, V. N. . (2022). A CHECKLIST OF BIRDS AND DIVERSITY OF AVIAN FAUNA IN MUDASARLOVA RESERVOIR OF VISAKHAPATNAM, INDIA . Journal Of Advanced Zoology, 42(02), 165–175. https://doi.org/10.17762/jaz.v42i02.51
43. Faisal, H. T. ., Abid, M. K. ., & Abed, A. . (2022). Study Of Some Biochemical Parameters in Dose During Pregnancy in Goats. Journal Of Advanced Zoology, 43(1), 01–06. https://doi.org/10.17762/jaz.v43i1.109
44. Wankhade, L. N. . (2022). STUDY ON BUTTERFLY FAUNA OF KARANJA (GHADGE) TAHSIL OF DISTRICT WARDHA (MAHARASHTRA). Journal Of Advanced Zoology, 42(02), 186–193. https://doi.org/10.17762/jaz.v42i02.53
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Mar 26, 2023
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Dr. Ali G Alghamdi. (2023). Management of Perforation of the Third and Fourth Part of the Duodenum; A Review Article. Journal of Population Therapeutics and Clinical Pharmacology, 30(4), 17-24. https://doi.org/10.47750/jptcp.2023.30.04.003
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How to Cite
Dr. Ali G Alghamdi. (2023). Management of Perforation of the Third and Fourth Part of the Duodenum; A Review Article. Journal of Population Therapeutics and Clinical Pharmacology, 30(4), 17-24. https://doi.org/10.47750/jptcp.2023.30.04.003