title: Duodenal web in an adult presenting with acute pancreatitis and acquired megaduodenum: report of a case.
abstract: Duodenal webs are a cause of intestinal atresia in infants and surgical repair is the established treatment of choice. However, the late-onset postoperative complications have not been adequately studied, especially in adults who have undergone surgical interventions as infants. This report describes the case of a 65-year-old female patient who presented with consecutive episodes of acute pancreatitis and a history of duodenal atresia repaired by a gastrojejunostomy in early infancy. Imaging studies revealed the presence of megaduodenum and suggested the possibility of impacted stones at the ampulla of Vater. An intact duodenal web at the level of papilla of Vater was revealed during surgery. Excision of the web, tapering of the duodenum and duodenojejunostomy was performed to relieve the obstructive cause of pancreatitis and to restore the intestinal continuity. At the 1-year follow-up, the patient is free of any symptoms, has no diet restrictions, and has increased her body weight as well.
authors.affiliation: Department of Surgery, University College of London Hospital NHS Foundation Trust, London, UK.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Lytras
authors.forename: Steven W
authors.initials: SW
authors.lastname: Olde-Damink
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Imber
authors.forename: Adrian
authors.initials: A
authors.lastname: Hatfield
authors.forename: Zahir
authors.initials: Z
authors.lastname: Amin
authors.forename: Massimo
authors.initials: M
authors.lastname: Malagó
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D002763:Cholecystectomy; D003937:Diagnosis, Differential; D004380:Duodenal Obstruction / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D004386:Duodenum / Q000002:abnormalities / Q000601:surgery; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000379:methods; D006801:Humans; D007409:Intestinal Atresia; D007582:Jejunostomy / Q000379:methods; D007583:Jejunum / Q000601:surgery; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013270:Stomach / Q000601:surgery; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000002:abnormalities / Q000601:surgery