Difference between revisions of "Acute duodenitis"

From Libre Pathology
Jump to navigation Jump to search
(redirect w/ cat.)
 
(+images, +infobox)
 
(One intermediate revision by the same user not shown)
Line 1: Line 1:
#redirect [[Duodenum#Acute_duodenitis]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Acute duodenitis -- intermed mag.jpg
| Width      =
| Caption    = Acute duodenitis. [[H&E stain]].
| Synonyms  =
| Micro      = [[neutrophil]]s - "found without searching", [[eosinophil]]s - "found without searching", plasma cells (increased), intraepithelial lymphocytes
| Subtypes  =
| LMDDx      =
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[duodenum]]
| Assdx      = [[Helicobacter gastritis]]
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  = erythema
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        = dependent on underlying cause
}}
'''Acute duodenitis''', abbreviated '''AD''', is an acute inflammatory process of the [[duodenum]]. It is relatively uncommon.
 
==General==
DDx:
*Infection.
**Helicobactor organisms in the [[stomach]].
***Helicobacter ''not'' seen unless gastric metaplasia is present.<ref>{{Cite journal  | last1 = Madsen | first1 = JE. | last2 = Vetvik | first2 = K. | last3 = Aase | first3 = S. | title = Helicobacter-associated duodenitis and gastric metaplasia in duodenal ulcer patients. | journal = APMIS | volume = 99 | issue = 11 | pages = 997-1000 | month = Nov | year = 1991 | doi =  | PMID = 1683540 }}</ref>
*Medications ([[NSAID]]s).
*[[Crohn's disease]] (usually focal/patchy).
*[[Portal hypertension]] (portal hypertensive duodenopathy).<ref name=pmid12003421>{{Cite journal  | last1 = Shudo | first1 = R. | last2 = Yazaki | first2 = Y. | last3 = Sakurai | first3 = S. | last4 = Uenishi | first4 = H. | last5 = Yamada | first5 = H. | last6 = Sugawara | first6 = K. | title = Duodenal erosions, a common and distinctive feature of portal hypertensive duodenopathy. | journal = Am J Gastroenterol | volume = 97 | issue = 4 | pages = 867-73 | month = Apr | year = 2002 | doi = 10.1111/j.1572-0241.2002.05602.x | PMID = 12003421 }}</ref>
*[[Celiac sprue]].
 
==Microscopic==
Features:
*Intraepithelial lymphocytes.
*[[Neutrophil]]s - "found without searching" - '''key feature'''.
*[[Eosinophil]]s - "found without searching" - '''key feature'''.
*[[Plasma cell]]s (increased).
 
Notes:
*One needs stomach concurrent biopsies to r/o Helicobactor.
*Erosions make celiac sprue much less likely.
*Presence of chronic inflammation useful for NSAIDs vs. Helicobacter organisms:
**[[NSAID]]s not commonly assoc. with acute inflammation;<ref name=pmid8406146>{{cite journal |author=Taha AS, Dahill S, Nakshabendi I, Lee FD, Sturrock RD, Russell RI |title=Duodenal histology, ulceration, and Helicobacter pylori in the presence or absence of non-steroidal anti-inflammatory drugs |journal=Gut |volume=34 |issue=9 |pages=1162–6 |year=1993 |month=September |pmid=8406146 |pmc=1375446 |doi= |url=}}</ref> thus, without chronic inflammation NSAIDs are unlikely.
***Acute NSAID-related duodenitis reported.<ref name=pmid18158085>{{cite journal |author=Hashash JG, Atweh LA, Saliba T, ''et al.'' |title=Acute NSAID-related transmural duodenitis and extensive duodenal ulceration |journal=Clin Ther |volume=29 |issue=11 |pages=2448–52 |year=2007 |month=November |pmid=18158085 |doi=10.1016/j.clinthera.2007.11.012 |url=}}</ref>
 
===Images===
<gallery>
Image: Acute duodenitis -- low mag.jpg | AD - low mag.
Image: Acute duodenitis -- intermed mag.jpg | AD - intermed. mag.
Image: Acute duodenitis -- high mag.jpg | AD - high mag.
Image: Acute duodenitis -- very high mag.jpg | AD - very high mag.
</gallery>
 
==Sign out==
<pre>
DUODENUM, BIOPSY:
- ACUTE DUODENITIS.
</pre>
 
===Acute on chronic duodenitis===
<pre>
DUODENUM, BIOPSY:
- ACUTE ON CHRONIC DUODENITIS.
</pre>
 
====Micro====
The sections show small bowel mucosa with intraepithelial neutrophils. The epithelium shows nuclear hyperchromasia, pseudostratification and nuclear enlargement; however, it matures toward the surface (reactive changes of the epithelium).
 
Brunner's glands are found focally in the lamina propria. Gastric foveolar-type epithelium
is identified. Lamina propria plasma cells are abundant.
 
==See also==
*[[Duodenum]].
*[[Chronic duodenitis]].
*[[Crohn's disease]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Duodenum]]

Latest revision as of 00:32, 30 April 2014

Acute duodenitis, abbreviated AD, is an acute inflammatory process of the duodenum. It is relatively uncommon.

Acute duodenitis
Diagnosis in short

Acute duodenitis. H&E stain.
LM neutrophils - "found without searching", eosinophils - "found without searching", plasma cells (increased), intraepithelial lymphocytes
Site duodenum
Associated Dx Helicobacter gastritis
Prevalence uncommon
Endoscopy erythema
Prognosis benign
Treatment dependent on underlying cause

General

DDx:

Microscopic

Features:

Notes:

  • One needs stomach concurrent biopsies to r/o Helicobactor.
  • Erosions make celiac sprue much less likely.
  • Presence of chronic inflammation useful for NSAIDs vs. Helicobacter organisms:
    • NSAIDs not commonly assoc. with acute inflammation;[3] thus, without chronic inflammation NSAIDs are unlikely.
      • Acute NSAID-related duodenitis reported.[4]

Images

  • AD - low mag.

  • AD - intermed. mag.

  • AD - high mag.

  • AD - very high mag.

Sign out

DUODENUM, BIOPSY:
- ACUTE DUODENITIS.

Acute on chronic duodenitis

DUODENUM, BIOPSY:
- ACUTE ON CHRONIC DUODENITIS.

Micro

The sections show small bowel mucosa with intraepithelial neutrophils. The epithelium shows nuclear hyperchromasia, pseudostratification and nuclear enlargement; however, it matures toward the surface (reactive changes of the epithelium).

Brunner's glands are found focally in the lamina propria. Gastric foveolar-type epithelium is identified. Lamina propria plasma cells are abundant.

See also

References

  1. ↑ Madsen, JE.; Vetvik, K.; Aase, S. (Nov 1991). "Helicobacter-associated duodenitis and gastric metaplasia in duodenal ulcer patients.". APMIS 99 (11): 997-1000. PMID 1683540.
  2. ↑ Shudo, R.; Yazaki, Y.; Sakurai, S.; Uenishi, H.; Yamada, H.; Sugawara, K. (Apr 2002). "Duodenal erosions, a common and distinctive feature of portal hypertensive duodenopathy.". Am J Gastroenterol 97 (4): 867-73. doi:10.1111/j.1572-0241.2002.05602.x. PMID 12003421.
  3. ↑ Taha AS, Dahill S, Nakshabendi I, Lee FD, Sturrock RD, Russell RI (September 1993). "Duodenal histology, ulceration, and Helicobacter pylori in the presence or absence of non-steroidal anti-inflammatory drugs". Gut 34 (9): 1162–6. PMC 1375446. PMID 8406146. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375446/.
  4. ↑ Hashash JG, Atweh LA, Saliba T, et al. (November 2007). "Acute NSAID-related transmural duodenitis and extensive duodenal ulceration". Clin Ther 29 (11): 2448–52. doi:10.1016/j.clinthera.2007.11.012. PMID 18158085.
Retrieved from "https://librepathology.org/w/index.php?title=Acute_duodenitis&oldid=31214"