Anterior Wall Of Duodenum Research Articles

Duodenal ulcer perforation in a 3-year-old child with lower respiratory tract infection and hyperthyroidism

Peptic ulcer disease (PUD) in children remains rare and difficult to diagnose before the onset of complications. We describe a 3-year-old child with perforated duodenal ulcer, associated with lower respiratory tract infection and hyperthyroidism. Upper GI endoscopy revealed three clean based ulcers in the first part of duodenum, erect chest x-ray showed bilateral gas under diaphragm and CT scan confirmed massive pneumoperitoneum. Emergency exploratory laparotomy detected perforation in the anterior wall of duodenum, managed with simple sutural closure. PUD in children is rare and high index of suspicion is required to prevent complications.

Laparoscopic Repair of Duodenal Perforation by “Hanging Method” -Technique and Benefits

Background: Laparoscopic repair of duodenal perforation using the omental patch is one of the traditional techniques, which gives better postoperative recovery in patients with little chances of abdominal wound infection. This article is about the technique used for the laparoscopic repair of the duodenal perforation by Grahams patch with a twist in the conventional technique. Methods: In Hanging method of duodenal repair first, an intra-corporeal suture is taken at the upper margin of perforation and both end of the thread is taken out of anterior abdominal wall and duodenum is pulled up. Now under vision the next two parallel sutures are passed, thus avoiding the posterior duodenal wall incorporation. Finally omentum flap is used for the closure of perforation. Conclusions: The laparoscopic closure of the duodenal perforation by “Hanging Method” is an appropriate Laparoscopic technique, as “hanging” the anterior wall of duodenum gives us better vision of the posterior wall of duodenum, while taking the suture through anterior duodenal wall. Further since the gall bladder is retracted there is an easy available working space for intracorporeal suturing.

Bile flow mechanism and function of choledochoduodenal junction (author's transl)

The present study was made to investigate in detail the mechanism of the bileflow into the duodenum in rabbit. The bile flow through the choledochoduodenaljunction was measured with a constant-rate infusion apparatus or with a constant-pressure perfusion apparatus. Pressures in gall-bladder, common bile duct and duodenum were recorded with pressure transducer. The electrical activities were recorded with bipolar electrodes which were implanted in the choledochoduodenal junction (muscle of Oddi) and the anterior wall of duodenum. The results obtained are as follows:1. The activity of choledochoduodenal junction appears to be affected by the change in duodenal wall muscle tone.2. The important factors controlling the bile flow are the rhtyhmic movements of both the choledochoduodenal junction and the duodenal wall.3. The common bile duct plays a role to regulate the pressure of biliary truct.4. Electrical and mechanical stimulations to gall-bladder were ineffective to cause the relaxing reflex of the muscle of Oddi.5. The function of gall-bladder is to accumulate the bile and control the pressure of common bile duct.From these results, it seems unlikely that the choledochoduodenal junction (muscle of Oddi) would be independent of duodenum in rabbit.