Idiopathic Megaduodenum in a Teenager: A Case Report

被引:0
|
作者
Eze, Anthony N. [1 ,2 ]
Eze, Akachukwu N. [3 ]
Chime, Chinecherem M. [3 ]
Chen, Fengming [4 ]
Moris, Dimitrios [1 ]
Schmitz, Robin [5 ]
Fitzgerald, Tamara N. [1 ,2 ]
机构
[1] Duke Univ, Dept Surg, Med Ctr, Durham, NC 27710 USA
[2] Duke Univ, Duke Global Hlth Inst, Durham, NC 27710 USA
[3] Howard Univ, Coll Med, Dept Med, Washington, DC USA
[4] Duke Univ, Med Ctr, Dept Pathol, Durham, NC USA
[5] Univ Pittsburgh, Med Ctr, Dept Surg, Pittsburgh, PA USA
关键词
malnutrition; small bowel obstruction; idiopathic; superior mesenteric artery syndrome; duodenal volvulus; megaduodenum; DUODENOPLASTY;
D O I
10.7759/cureus.51930
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Megaduodenum is a rare clinical syndrome characterized by significant duodenal dilation, elongation, and hypertrophy. Given its rarity and nonspecific clinical manifestations, megaduodenum may be misdiagnosed, leading to delays in surgical care and increased morbidity. We describe a case of idiopathic megaduodenum in a teenage Caucasian female, who presented with a five-year history of halitosis, recurrent belching, bloating, nausea and vomiting, and postprandial epigastric abdominal pain. She was diagnosed with megaduodenum by dramatic findings on contrast radiography. She developed a duodenal volvulus necessitating emergency exploratory laparotomy, during which a duodenal plication and a side-to-side duodenojejunostomy were performed. Exploratory laparotomy and histopathological analysis were unrevealing of any definitive abnormalities to explain her megaduodenum. Postoperatively, she developed two early small bowel obstructions, both from subsequent adhesions requiring repeat laparotomy with adhesiolysis. She has subsequently recovered without incident. Diagnosis and accurate classification of megaduodenum requires surgical exploration with a full-thickness biopsy and subsequent histopathologic analysis to rule out obstructive or functional disorders of the duodenum. Treatment of megaduodenum depends on the underlying cause and degree of duodenal distention. It is crucial that clinicians are knowledgeable of the various surgical options, their indications, and the potential postoperative complications that may arise.
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页数:9
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