Cystic dystrophy of the duodenal wall associated with chronic alcoholic pancreatitis
| Autor: | Jean-Jacques Meurisse, Djamel Belloula, Pierre Coutarel, Marie-Pierre Dellion, Alex Pariente, Bories C, René-Louis Vitte, Vincent Jouannaud, Jean-François Cadranel, Hervé Tossou, Joël Butel, Philippe Rocher, Hervé Hagège, J. P. Latrive, Florence Skinazi, Claude Eugène, Martine Blazquez |
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| Rok vydání: | 2006 |
| Předmět: |
Abdominal pain
medicine.medical_specialty Pancreatic disease business.industry medicine.medical_treatment Gastroenterology Octreotide Dystrophy Retrospective cohort study General Medicine medicine.disease Pancreaticoduodenectomy Duodenal Diseases Surgery Medicine Pancreatitis medicine.symptom business medicine.drug |
| Zdroj: | Gastroentérologie Clinique et Biologique. 30:580-586 |
| ISSN: | 0399-8320 |
| Popis: | Summary Aim of the study The aim of this retrospective multicenter study was to collect data from patients with chronic alcoholic pancreatitis and cystic dystrophy of the duodenal wall in order to better understand the outcome after medical, endoscopic and/or surgical treatment. Patients and methods The data from medical records of 23 patients consecutively seen in ten primary referral centers from January 1990 to July 2004 were studied. Clinical, biological, and endoscopic features as well as imaging findings were recorded. Response to treatment was noted. Results Twenty-three patients (20 men), aged 45 years (range: 30-66), with chronic alcohol intake, cystic dystrophy of the duodenal wall, and previously known (N = 14) or simultaneously diagnosed (N = 9) chronic pancreatitis were included. Symptoms most frequently encountered were abdominal pain (N = 22) and weight loss (N = 16). An abdominal ultrasound was available for 10 patients, abdominal computed tomography for 22, upper endoscopy for 18, and endoscopic ultrasonography for 22. Endoscopic ultrasonography enabled diagnosis of cystic dystrophy of the duodenal wall in 19/22 patients. Six patients were symptom-free after alcohol withdrawal. Seven patients received octreotide 200 to 400 mg per day, 5 of whom subsequently underwent surgery (71%). Fourteen patients out of 23 were operated on (61%), 11 of whom underwent pancreaticoduodenectomy and remained symptom-free for 47 months follow-up. Mean follow-up was 56 months (range: 2-78) for non surgical patients (39%) and 47 months (range: 12-108) for surgical patients (61%). Conclusion Cystic dystrophy of the duodenal wall complicating chronic alcoholic pancreatitis may be the revealing sign of pancreatitis. Endoscopic ultrasongraphy is the most reliable imaging method for diagnosis. Pancreaticoduodenectomy is the most frequently employed definitive treatment. |
| Databáze: | OpenAIRE |
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