Packed with pills-obstructing duodenal web in the setting of intestinal malrotation:A case report  

作　　者：Kimberline Chew Sarah Bellemare Akash Kumar 

机构地区：[1]Internal Medicine,Montefiore Medical Center,Bronx,NY 10467,United States [2]Division of Hepato-biliary Surgery,Montefiore Medical Center,Bronx,NY 10467,United States [3]Division of Gastroenterology,Montefiore Medical Center,Bronx,NY 10467,United States

出　　处：《World Journal of Gastrointestinal Endoscopy》2023年第2期77-83,共7页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND The incidence of intestinal malrotation in adults has been reported to only be about 0.2%.Duodenal web as a cause of intestinal obstruction is rare,with an incidence of about 1:20000-1:40000.Furthermore,when described,these conditions are usually seen in early life and very infrequently in adulthood.CASE SUMMARY We report a case of a middle-aged woman with intestinal malrotation who presented with a three-month history of right-sided abdominal pain,early satiety,and a 22-pound weight loss.Patient underwent an esophagogastroduodenoscopy,which demonstrated numerous retained pills in a deformed first portion of the duodenum,concerning for a partial gastric outlet obstruction.An upper gastrointestinal series showed marked distention of the proximal duodenum with retained debris and the presence of a windsock sign,increasing the suspicion of a duodenal web.The patient subsequently underwent surgical intervention where a duodenal web with two lumens was noted and resected,opening the duodenum.There were over 150 pill capsules that were removed.The patient is doing well after this intervention.CONCLUSION Both intestinal malrotation and duodenal webs are infrequently encountered in the adult population.These pathologies can also present with nonspecific abdominal symptoms such as chronic abdominal pain and nausea.Hence,providers might not consider these pathologies in the differential for patients who present with vague symptoms which can lead to delay in management and increased mortality and morbidity.

关 键 词：Intestinal obstruction Intestinal malrotation Duodenal web Pill impaction Duodenal distention Case report 

分 类 号：R574.5[医药卫生—消化系统]