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Management of the Uncinate Process in No-Touch Laparoscopic Pancreaticoduodenectomy
Published on: May 5, 2023
[Duodenal duplication revealed by acute pancreatitis]
C Le Stradic1, J Aroulandom1, H Kotobi2
1Service de nutrition et gastroentérologie pédiatriques, hôpital Trousseau, AP-HP, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France.
Introduction:
Duodenal duplications are rare congenital malformations whose revealing signs are highly variable and nonspecific.
Observation:
We report the case of a female infant who presented with neonatal acute pancreatitis complicated by recurrent ascites, profound hypoalbuminemia responsible for pleural and pericardial effusions, revealing a duodenal duplication cyst. The unusual and original clinical presentation as well as the difficulty detecting the duplication radiologically delayed the diagnosis. A prolonged medical treatment with octreotide, albumin infusions, and exclusive parenteral nutrition led to an almost total disappearance of the ascites before surgery. The outcome was favorable after surgical removal of the duplication with 1 year of follow-up.
Conclusion:
The diagnosis of duodenal duplication can be difficult and it may be necessary to repeat the ultrasound examinations. Surgical resection is delicate, especially when there is an abundant pancreatic ascites. Therefore, an adequate prolonged medical treatment to reduce this ascites is recommended before the surgery.
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