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A Rosebud-like Retrograde View of the Duodenal Bulb
IMAGE OF THE MONTH A Rosebud-like Retrograde View of the Duodenal Bulb Athanasios D. Sioulas, Iosif Beintaris, and Konstantinos Triantafyllou Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, Athens, Greece
n 87-year-old man was referred to our department for an expert opinion regarding a video capsule finding of suspected postbulbar duodenal stenosis. He had undergone small bowel examination, with video capsule endoscopy indicated for the evaluation of obscure occult gastrointestinal bleeding. According to our assessment, the capsule entered the duodenal bulb headfirst and immediately turned around, allowing an unusual “rosebud-like” retrograde view of the pylorus. As shown in the images (Figures A, B, and C), the flat pyloric mucosa protrudes into the duodenum
A
surrounded by the villi-covered bulbar epithelium. Of importance, this rare duodenal aspect of the pylorus should not be misinterpreted as a mass or stenosis. The absence of such a finding was subsequently confirmed by upper gastrointestinal endoscopy. Conflicts of interest The authors disclose no conflicts. © 2014 by the AGA Institute 1542-3565/$36.00 http://dx.doi.org/10.1016/j.cgh.2014.06.013
Clinical Gastroenterology and Hepatology 2014;12:xvii
n 87-year-old man was referred to our department for an expert opinion regarding a video capsule finding of suspected postbulbar duodenal stenosis. He had undergone small bowel examination, with video capsule endoscopy indicated for the evaluation of obscure occult gastrointestinal bleeding. According to our assessment, the capsule entered the duodenal bulb headfirst and immediately turned around, allowing an unusual “rosebud-like” retrograde view of the pylorus. As shown in the images (Figures A, B, and C), the flat pyloric mucosa protrudes into the duodenum
A
surrounded by the villi-covered bulbar epithelium. Of importance, this rare duodenal aspect of the pylorus should not be misinterpreted as a mass or stenosis. The absence of such a finding was subsequently confirmed by upper gastrointestinal endoscopy. Conflicts of interest The authors disclose no conflicts. © 2014 by the AGA Institute 1542-3565/$36.00 http://dx.doi.org/10.1016/j.cgh.2014.06.013
Clinical Gastroenterology and Hepatology 2014;12:xvii