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UNUSUAL CONDITIONS IN THE DUODENUM AND THEIR SIGNIFICANCE: MEMBRANOUS OBSTRUCTION OF THE LUMEN, DIVERTICULA AND CARCINOMA

UNUSUAL CONDITIONS IN THE DUODENUM AND THEIR SIGNIFICANCE: MEMBRANOUS OBSTRUCTION OF THE LUMEN,... Abstract A tabulation of known unusual conditions in the duodenum is evidence that the theme is a large one. Included in the list are (1) conditions resulting from misdirected developmental processes, and (2) conditions resulting from injury or disease. In the first group are anatomic variations of all types, including abnormal position, mobility, blood supply and peritoneal relations of the organ, various forms of complete or partial obstruction, and primary diverticula. In the second group are obstructions caused by foreign bodies, impacted gallstones, or intestinal parasites, acquired diverticula, and both benign and malignant tumors of the duodenum. Such lesions are not only of academic interest, they are also of practical importance in the diagnosis and treatment of obscure, and sometimes apparently simple diseases. I have selected for brief consideration here three unusual conditions; membranous obstruction of the lumen of the duodenum in an adult, diverticula, and carcinoma of the duodenum. MEMBRANOUS References 1. Moore, N.: Multiple Diverticula of the Small Intestine with Congenital Stricture of the Duodenum , Tr. Path. Soc. London 35:202-204, 1884. 2. Silcock, A. Q.: Epithelioma of Ascending Colon; Enterocolitis; Congenital Duodenal Septum, with Internal Diverticulum , Tr. Path. Soc. London , 36:207, 1885. 3. Wilkie, D. P. D.: Duodenal Diverticula and Duplicature of the Duodenal Wall , Edinburgh M. J. 11:219-229, 1913. 4. Keith, A.: Constrictions and Occlusions of the Alimentary Tract of Congenital or Obscure Origin , Brit. M. J. 1:301-304, 1910.Crossref 5. Terry, W. I., and Kilgore, A. R.: Congenital Stenosis of the Duodenum in an Adult , J. A. M. A. 66:1774-1776 ( (June 3) ) 1916.Crossref 6. Tandler, J.: Zur Entwicklungsgeschichte des menschlichen Duodenum in frühen Embryonalstudien , Morphol. Jahrb. 29:187-216, 1900. 7. Nagel, G. W.: Right Paraduodenal Hernia , J. A. M. A. 81:907-912 ( (Sept. 15) ) 1923.Crossref 8. Toldt, C.: Bau und Wachsthumsveränderungen der Nekröse des menschlichen Darmkanales , Ed. 2, Vienna, Tempsky, 1889. 9. Andrews, E. W.: Duodenal Diverticula , J. A. M. A. 77:1309-1311 ( (Oct. 22) ) 1921.Crossref 10. Basch, S.: Diverticulum of the Duodenum, with a Report of a Case Diagnosed During Life and Successfully Operated on , Am. J. M. Sc. 153:833-841 ( (June) ) 1917.Crossref 11. Case, J. T.: Diverticula of the Small Intestine, Other than Meckel's Diverticulum , J. A. M. A. 75:1463-1470 ( (Nov. 27) ) 1920.Crossref 12. Cole, L. G., and Roberts, D.: Diverticula of the Duodenum , Surg., Gynec. & Obst. 31:376-382 ( (Oct.) ) 1920. 13. Cole, L. G., and Steiner, J. M.: The Technical and Clinical Use of the X-Ray , in Keen's Surgery, Philadelphia, Saunders , 8:764-804, 1921. 14. Cullen, E. K.: Report of a Diverticulum of the First Portion of the Duodenum , Tr. South. Surg. Assoc. 33:364-369, 1920. 15. Downes, W. A.: Duodenal Diverticula , Ann. Surg. 76:43-51 ( (July) ) 1922. 16. Jones, W. M.: Duodenal Diverticulum with Ulcer on the Opposite Wall , J. A. M. A. 78:1706-1707 ( (June 3) ) 1922. 17. Maclean, N. J.: Diverticulum of the Duodenum , Surg., Gynec. & Obst. 37:6-13 ( (July) ) 1923. 18. Moore, E. C.: Duodenal Diverticula, with Report of a Case , Arch. Surg. 1:513-523 ( (Nov.) ) 1920. 19. Murchison, D. R.: Duodenal Diverticulum with Pyloric Ulcer , J. A. M. A. 75:1329-1330 ( (Nov. 13) ) 1920. 20. Ritchie, H. P., and McWhorter, G. D.: Duodenal Diverticula, with Report of a Case Associated with a Duodenal Ulcer , Surg., Gynec. & Obst. 25:485-489 ( (Nov.) ) 1917. 21. Spriggs, E. I.: Duodenal Diverticula , Brit. J. Surg. 8:18-26 ( (July) ) 1920. 22. Mahler, R.: Personal communication. 23. Mayo, W. J.; Wilson, L. B., and Giffin, H. Z.: Acquired Diverticulitis of the Large Intestine , Surg., Gynec. & Obst. 5:8-15, 1907. 24. Lewis, F. T., and Thyng, F. W.: The Regular Occurrence of Intestinal Diverticula in Embryos of the Pig, Rabbit and Man , Am. J. Anat. 7:505-519, 1907-1908. 25. Keith, A.: Diverticula of the Alimentary Tract of Congenital or of Obscure Origin , Brit. M. J. 1:376-380, 1910 26. On the Origin and Nature of Hernia , Brit. J. Surg. 11:455-475 ( (Jan.) ) 1924. 27. A complete study of duodenal diverticula is being made by Dr. V. C. Hunt, who has allowed me to use this material. 28. Carman, R. D.: The Roentgenologic Diagnosis of Duodenal Ulcer , Am. J. Roentgenol. 3:252-256 ( (May) ) 1916. 29. Cole (Footnote 8, fifth reference). 30. Robertson, H. E., and Hargis, E. H.: Personal communication. 31. Finney, J. M. T., Surgical Treatment of Diseases of the Stomach 32. Ochsner, A. J.: Surgical Diagnosis and Treatment, Philadelphia , Lea and Febiger , 2:703-762, 1921. 33. Anschütz, W., and Konjetzny, G. E.: Die Geschwülste des Magens , Deutsch. Chir. 1:387 ( (Part I) ) 1921. 34. Borrmann, R.: Das Wachstum und die Verbreitungsweise des Magencarcinoms vom anatomischen und klinischen Standpunkte , Mitt. a. d. Grenzgeb. d. Med. u. Chir. Suppl. 1:376, 1901. 35. Judd, E. S.: Carcinoma of the Small Intestine , Journal-Lancet 39:159-169 ( (April 1) ) 1919. 36. Mayo, W. J.: The Prophylaxis of Cancer , Ann. Surg. 59:805-814, 1914. 37. Broders, A. C., and MacCarty, W. C.: Epithelioma , Surg., Gynec. & Obst. 27:141 ( (Aug.) ) 1918. 38. Robertson, H. E.: Personal communication. 39. Broders, A. C.: Personal communication. 40. Mayo, W. J.: Radical Operation for Cancer of the Pyloric End of the Stomach , J. A. M. A. 54:1608-1612 ( (May 14) ) 1910. 41. Moynihan, B. G. A.: Operations Upon the Stomach and Intestines , Oxford Surgery, New York, Oxford University Press, 2:555-648, 1919. 42. Swan, T.: Unpublished data. 43. Judd (Footnote 19). 44. Carman, R. D.: The Roentgen Diagnosis of Diseases of the Alimentary Canal , Ed. 2, Philadelphia, Saunders, 1920, p. 676. 45. Coffey, R. C.: Pancreato-enterostomy and Pancreatectomy , Ann. Surg. 1:1238-1264, 1909. 46. Mann, F. C., and Williamson, C. S.: The Experimental Production of Peptic Ulcer , Ann. Surg. 77:409-422 ( (April) ) 1923. 47. Kausch, W.: Das Carcinom der Papilla duodeni und seine radikale Entfernung , Beitr. z. klin. Chir. 78:439-486, 1912. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

UNUSUAL CONDITIONS IN THE DUODENUM AND THEIR SIGNIFICANCE: MEMBRANOUS OBSTRUCTION OF THE LUMEN, DIVERTICULA AND CARCINOMA

NAGEL, GUNTHER W.
Archives of Surgery , Volume 11 (4) – Oct 1, 1925
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References (39)

Publisher
American Medical Association
Copyright
Copyright © 1925 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1925.01120160042003
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Abstract

Abstract A tabulation of known unusual conditions in the duodenum is evidence that the theme is a large one. Included in the list are (1) conditions resulting from misdirected developmental processes, and (2) conditions resulting from injury or disease. In the first group are anatomic variations of all types, including abnormal position, mobility, blood supply and peritoneal relations of the organ, various forms of complete or partial obstruction, and primary diverticula. In the second group are obstructions caused by foreign bodies, impacted gallstones, or intestinal parasites, acquired diverticula, and both benign and malignant tumors of the duodenum. Such lesions are not only of academic interest, they are also of practical importance in the diagnosis and treatment of obscure, and sometimes apparently simple diseases. I have selected for brief consideration here three unusual conditions; membranous obstruction of the lumen of the duodenum in an adult, diverticula, and carcinoma of the duodenum. MEMBRANOUS References 1. Moore, N.: Multiple Diverticula of the Small Intestine with Congenital Stricture of the Duodenum , Tr. Path. Soc. London 35:202-204, 1884. 2. Silcock, A. Q.: Epithelioma of Ascending Colon; Enterocolitis; Congenital Duodenal Septum, with Internal Diverticulum , Tr. Path. Soc. London , 36:207, 1885. 3. Wilkie, D. P. D.: Duodenal Diverticula and Duplicature of the Duodenal Wall , Edinburgh M. J. 11:219-229, 1913. 4. Keith, A.: Constrictions and Occlusions of the Alimentary Tract of Congenital or Obscure Origin , Brit. M. J. 1:301-304, 1910.Crossref 5. Terry, W. I., and Kilgore, A. R.: Congenital Stenosis of the Duodenum in an Adult , J. A. M. A. 66:1774-1776 ( (June 3) ) 1916.Crossref 6. Tandler, J.: Zur Entwicklungsgeschichte des menschlichen Duodenum in frühen Embryonalstudien , Morphol. Jahrb. 29:187-216, 1900. 7. Nagel, G. W.: Right Paraduodenal Hernia , J. A. M. A. 81:907-912 ( (Sept. 15) ) 1923.Crossref 8. Toldt, C.: Bau und Wachsthumsveränderungen der Nekröse des menschlichen Darmkanales , Ed. 2, Vienna, Tempsky, 1889. 9. Andrews, E. W.: Duodenal Diverticula , J. A. M. A. 77:1309-1311 ( (Oct. 22) ) 1921.Crossref 10. Basch, S.: Diverticulum of the Duodenum, with a Report of a Case Diagnosed During Life and Successfully Operated on , Am. J. M. Sc. 153:833-841 ( (June) ) 1917.Crossref 11. Case, J. T.: Diverticula of the Small Intestine, Other than Meckel's Diverticulum , J. A. M. A. 75:1463-1470 ( (Nov. 27) ) 1920.Crossref 12. Cole, L. G., and Roberts, D.: Diverticula of the Duodenum , Surg., Gynec. & Obst. 31:376-382 ( (Oct.) ) 1920. 13. Cole, L. G., and Steiner, J. M.: The Technical and Clinical Use of the X-Ray , in Keen's Surgery, Philadelphia, Saunders , 8:764-804, 1921. 14. Cullen, E. K.: Report of a Diverticulum of the First Portion of the Duodenum , Tr. South. Surg. Assoc. 33:364-369, 1920. 15. Downes, W. A.: Duodenal Diverticula , Ann. Surg. 76:43-51 ( (July) ) 1922. 16. Jones, W. M.: Duodenal Diverticulum with Ulcer on the Opposite Wall , J. A. M. A. 78:1706-1707 ( (June 3) ) 1922. 17. Maclean, N. J.: Diverticulum of the Duodenum , Surg., Gynec. & Obst. 37:6-13 ( (July) ) 1923. 18. Moore, E. C.: Duodenal Diverticula, with Report of a Case , Arch. Surg. 1:513-523 ( (Nov.) ) 1920. 19. Murchison, D. R.: Duodenal Diverticulum with Pyloric Ulcer , J. A. M. A. 75:1329-1330 ( (Nov. 13) ) 1920. 20. Ritchie, H. P., and McWhorter, G. D.: Duodenal Diverticula, with Report of a Case Associated with a Duodenal Ulcer , Surg., Gynec. & Obst. 25:485-489 ( (Nov.) ) 1917. 21. Spriggs, E. I.: Duodenal Diverticula , Brit. J. Surg. 8:18-26 ( (July) ) 1920. 22. Mahler, R.: Personal communication. 23. Mayo, W. J.; Wilson, L. B., and Giffin, H. Z.: Acquired Diverticulitis of the Large Intestine , Surg., Gynec. & Obst. 5:8-15, 1907. 24. Lewis, F. T., and Thyng, F. W.: The Regular Occurrence of Intestinal Diverticula in Embryos of the Pig, Rabbit and Man , Am. J. Anat. 7:505-519, 1907-1908. 25. Keith, A.: Diverticula of the Alimentary Tract of Congenital or of Obscure Origin , Brit. M. J. 1:376-380, 1910 26. On the Origin and Nature of Hernia , Brit. J. Surg. 11:455-475 ( (Jan.) ) 1924. 27. A complete study of duodenal diverticula is being made by Dr. V. C. Hunt, who has allowed me to use this material. 28. Carman, R. D.: The Roentgenologic Diagnosis of Duodenal Ulcer , Am. J. Roentgenol. 3:252-256 ( (May) ) 1916. 29. Cole (Footnote 8, fifth reference). 30. Robertson, H. E., and Hargis, E. H.: Personal communication. 31. Finney, J. M. T., Surgical Treatment of Diseases of the Stomach 32. Ochsner, A. J.: Surgical Diagnosis and Treatment, Philadelphia , Lea and Febiger , 2:703-762, 1921. 33. Anschütz, W., and Konjetzny, G. E.: Die Geschwülste des Magens , Deutsch. Chir. 1:387 ( (Part I) ) 1921. 34. Borrmann, R.: Das Wachstum und die Verbreitungsweise des Magencarcinoms vom anatomischen und klinischen Standpunkte , Mitt. a. d. Grenzgeb. d. Med. u. Chir. Suppl. 1:376, 1901. 35. Judd, E. S.: Carcinoma of the Small Intestine , Journal-Lancet 39:159-169 ( (April 1) ) 1919. 36. Mayo, W. J.: The Prophylaxis of Cancer , Ann. Surg. 59:805-814, 1914. 37. Broders, A. C., and MacCarty, W. C.: Epithelioma , Surg., Gynec. & Obst. 27:141 ( (Aug.) ) 1918. 38. Robertson, H. E.: Personal communication. 39. Broders, A. C.: Personal communication. 40. Mayo, W. J.: Radical Operation for Cancer of the Pyloric End of the Stomach , J. A. M. A. 54:1608-1612 ( (May 14) ) 1910. 41. Moynihan, B. G. A.: Operations Upon the Stomach and Intestines , Oxford Surgery, New York, Oxford University Press, 2:555-648, 1919. 42. Swan, T.: Unpublished data. 43. Judd (Footnote 19). 44. Carman, R. D.: The Roentgen Diagnosis of Diseases of the Alimentary Canal , Ed. 2, Philadelphia, Saunders, 1920, p. 676. 45. Coffey, R. C.: Pancreato-enterostomy and Pancreatectomy , Ann. Surg. 1:1238-1264, 1909. 46. Mann, F. C., and Williamson, C. S.: The Experimental Production of Peptic Ulcer , Ann. Surg. 77:409-422 ( (April) ) 1923. 47. Kausch, W.: Das Carcinom der Papilla duodeni und seine radikale Entfernung , Beitr. z. klin. Chir. 78:439-486, 1912.

Journal

Archives of Surgery – American Medical Association

Published: Oct 1, 1925

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