case_images: PMC4773715_01
case_images: (A) The abdominal computed tomography (CT) scans demonstrated the dilatation of common bile duct (arrow), main pancreatic duct (arrowhead) and (B) mild wall thickening of the duodenum proximal portion (arrows). (C) The abdominal CT scans demonstrated the enlargement of pancreatic head (arrows) and (D) the swelling of the duodenal wall (arrows).
case_images: kjim-2014-338f1.jpg
case_images: PMC4773715_01_kjim-2014-338f1.jpg
case_images: f1-kjim-2014-338
case_images: Moreover, abdominal computed tomography (CT) scans showed dilatation of the common bile duct and the main pancreatic duct (Fig. 1A) due to stenosis at the pancreas head portion and mild wall thickening of the duodenum proximal portion (Fig. 1B). The CT scans performed after admission showed dilatation of the common bile duct and the main pancreatic duct due to enlargement and stenosis at the pancreas head (Fig. 1C), as well as edema of the duodenal wall (Fig. 1D).
case_images: (A, B) The esophagogastroduodenoscopy revealed the polypoid mass with circumferential mucosal swelling with partial obstruction of the duodenal bulb. (C, D) The polypoid mass with circumferential mucosal swelling with nearly complete obstruction of the duodenal bulb.
case_images: kjim-2014-338f2.jpg
case_images: PMC4773715_01_kjim-2014-338f2.jpg
case_images: f2-kjim-2014-338
case_images: Esophagogastroduodenoscopy (EGD) showed circumferential submucosal edema with the appearance of a protruding mass in the superior descending angle and second portion of the duodenum, which resulted in partial duodenal obstruction (Fig. 2A and 2B). EGD revealed a polypoid mass with circumferential mucosal swelling with nearly complete obstruction of the duodenum (Fig. 2C and 2D).
case_images: (A) The circumferential enlargement of the duodenal mucosa was found in the proximal duodenum and these lesions manifested as a cause of duodenal obstruction. (B) Lobular proliferation, increase size, and number with separated by thin fibrous septae of Brunner's glands are noted (H&E, x40).
case_images: kjim-2014-338f3.jpg
case_images: PMC4773715_01_kjim-2014-338f3.jpg
case_images: f3-kjim-2014-338
case_images: Circumferential enlargement of the duodenal mucosa was found in the proximal duodenum, in which the lesion was suspected to manifest as a cause of duodenal obstruction (Fig. 3A). Some of the ducts were dilated and infiltration of lymphocytes with some lymphoid follicles was also observed (Fig. 3B).