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Tytuł:
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Pancreaticoduodenal and choledochal hemangiomatosis with vascular variation in a child: a rare disease with challenge starts from diagnosis-a case report.
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Autorzy:
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Tian D; Department of HPB Surgery, The Second Affiliated Hospital of Kunming Medical University, 374 Burma Road, Kunming, 650101, Yunnan, China.
Zhu H; Department of HPB Surgery, The Second Affiliated Hospital of Kunming Medical University, 374 Burma Road, Kunming, 650101, Yunnan, China.
Wei X; Department of HPB Surgery, The Second Affiliated Hospital of Kunming Medical University, 374 Burma Road, Kunming, 650101, Yunnan, China. .
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Źródło:
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World journal of surgical oncology [World J Surg Oncol] 2022 Sep 07; Vol. 20 (1), pp. 286. Date of Electronic Publication: 2022 Sep 07.
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Typ publikacji:
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Case Reports; Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BioMed Central, 2003-
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MeSH Terms:
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Choledocholithiasis*/pathology
Hemangioma*/pathology
Pancreatic Neoplasms*/diagnosis
Pancreatic Neoplasms*/pathology
Pancreatic Neoplasms*/surgery
Child ; Humans ; Infant ; Pancreas/blood supply ; Pancreas/diagnostic imaging ; Pancreas/surgery ; Rare Diseases/pathology
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References:
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Contributed Indexing:
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Keywords: Case report; Choledoch; Duodenum; Hemangiomatosis; Misdiagnosis; Pancreas; Vascular variation
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Entry Date(s):
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Date Created: 20220907 Date Completed: 20220909 Latest Revision: 20220911
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Update Code:
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20240105
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PubMed Central ID:
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PMC9450330
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DOI:
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10.1186/s12957-022-02737-5
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PMID:
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36071524
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Background: Visceral hemangiomatosis is a benign tumor (rarer than hemangioma) that has not been reported to occur in the pancreas, duodenum, or choledoch. It can be easily confused with other pancreatic tumors or choledocholithiasis. Herein, we describe a case of a child with pancreaticoduodenal and choledochal hemangiomatosis and the key characteristics for the accurate diagnosis of pancreatic tumors based on previous reports and our findings.
Case Presentation: We report a case of a 2-year and 9-month-old child who presented with repeated and fluctuating jaundice for 3 months with a history of endoscopic stone removal in a local hospital, following the diagnosis of choledocholithiasis. An abdominal computed tomography revealed a previously undiagnosed pancreatic head tumor and celio-mesenteric trunk (a rare vascular variation). This was misdiagnosed as a pancreatic neuroendocrine tumor. Since the patient's parents refused FNA biopsy and insisted on surgery, pancreaticoduodenectomy was performed; however, postoperatively, the child was correctly diagnosed with pancreaticoduodenal and choledochal hemangiomatosis. Although the patient was in good condition and had gained 4 kg in weight 3 months postoperatively, pancreaticoduodenectomy could have been avoided if an accurate diagnosis had been established before or during the operation.
Conclusion: Our report highlights the difficulty in diagnosing visceral hemangiomatosis. Radiologists, endoscopists, and surgeons should consider this possibility in cases of repeated and fluctuating jaundice that cannot be explained by choledocholithiasis alone.
(© 2022. The Author(s).)
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