title: Megaduodenum in a patient with acromegaly.
abstract: BACKGROUND
  Acromegaly is associated with enlargement of all organs including the gastro intestinal system. However, there are no previous reports of occurrence of megaduodenum in patients with acromegaly.
  
  
  CONCLUSIONS
  We present the case of a 47 year old male who was diagnosed to have acromegaly 13 years ago and had undergone transsphenoidal surgery twice with incomplete removal of the pituitary macro-adenoma and received radiotherapy following the second surgery. Patient has been on replacement therapy for hypocortisolism, hypothyroidism and hypogonadism since 10 years. Post glucose growth hormone level continued to remain unsuppressed; however, patient never received any medical therapy for acromegaly. He was evaluated with esophago-gastro-duodenoscopy for recurrent abdominal pain and distension, which showed an elongated and tortuous megaduodenum. These findings were verified with a barium study which revealed dilated stomach, first and second part of duodenum with no evidence of a distal obstruction.
  
  
  CONCLUSIONS
  We report this finding in view of the rare association.
authors.affiliation: Department of Endocrinology, St. Johns Medical College Hospital, Bangalore, India .
authors.forename: Belinda
authors.initials: B
authors.lastname: George
authors.forename: D
authors.initials: D
authors.lastname: Vinay
authors.forename: J
authors.initials: J
authors.lastname: Moolechery
authors.forename: V
authors.initials: V
authors.lastname: Mathew
authors.forename: R
authors.initials: R
authors.lastname: Anantharaman
authors.forename: V
authors.initials: V
authors.lastname: Ayyar
authors.forename: G
authors.initials: G
authors.lastname: Bantwal
keywords: Acromegaly; duodenum; megaduodenum
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