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Difference between revisions of "Duodenum"
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→Acute duodenitis: more
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(→Acute duodenitis: more) |
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==Acute duodenitis== | ==Acute duodenitis== | ||
=== | ===General=== | ||
DDx: | |||
*Infection. | *Infection. | ||
**Helicobactor organisms in the [[stomach]]. | **Helicobactor organisms in the [[stomach]]. | ||
*Medications (NSAIDs). | *Medications (NSAIDs). | ||
*Crohn's disease (usually focal/patchy). | *Crohn's disease (usually focal/patchy). | ||
*Portal hypertension. | |||
*Celiac sprue. | *Celiac sprue. | ||
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**NSAIDs 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. | **NSAIDs 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> | ***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> | ||
==Peptic duodenitis== | |||
===General=== | |||
*Due to peptic ulcer disease. | |||
**Strong association of [[Helicobacter gastritis]]. | |||
===Microscopic=== | |||
Features:<ref name=Ref_GLP145>{{Ref GLP|145}}</ref> | |||
*Gastric foveolar metaplasia. | |||
*Brunner's gland hyperplasia. | |||
===Stains=== | |||
Foveolar metaplasia: | |||
*[[PAS stain]] +ve.<ref name=Ref_GLP145>{{Ref GLP|145}}</ref> | |||
*[[Mucicarmine stain]] +ve. | |||
=Weird stuff= | =Weird stuff= | ||