BACKGROUND Congenital duodenal webs are rare in adults and can lead to various symptoms such as nausea,vomiting,and postprandial fullness.The treatment for this disease is mostly surgical.Endoscopic treatment techniqu...BACKGROUND Congenital duodenal webs are rare in adults and can lead to various symptoms such as nausea,vomiting,and postprandial fullness.The treatment for this disease is mostly surgical.Endoscopic treatment techniques have been developed and attempted for this disease.Endoscopic radial incision and cutting(RIC)techniques are reportedly very effective in benign anastomotic stricture.This case report highlights the effectiveness and safety of endoscopic RIC as a minimally invasive treatment for adult congenital duodenal webs.CASE SUMMARY A 23-year-old female patient with indigestion was referred to a tertiary hospital.The patient complained of postprandial fullness in the epigastric region.Previous physical examinations or blood tests indicated no abnormalities.Computed tomography revealed an eccentric broad-based delayed-enhancing mass-like lesion in the second portion of the duodenum.Endoscopy showed an enlarged gastric cavity and a significantly dilated duodenal bulb;a very small hole was observed in the distal part of the second portion,and scope passage was not possible.Gastrografin upper gastrointestinal series was performed,revealing an intraduodenal barium contrast-filled sac with a curvilinear narrow radiolucent rim,a typical"windsock"sign.Endoscopic RIC was performed on the duodenal web.The patient recovered uneventfully.Follow-up endoscopy showed a patent duodenal lumen without any residual stenosis.The patient reported complete resolution of symptoms at the 18-month follow-up.CONCLUSION Endoscopic RIC may be an effective treatment for congenital duodenal webs in adults.展开更多
BACKGROUND Endoscopic submucosal dissection(ESD)post-procedure stricture is a relatively common long-term complication following ESD treatment.A range of approaches has been implemented for the treatment of post-proce...BACKGROUND Endoscopic submucosal dissection(ESD)post-procedure stricture is a relatively common long-term complication following ESD treatment.A range of approaches has been implemented for the treatment of post-procedural stricture using endoscopic techniques such as endoscopic dilation,self-expandable metallic stent insertion,local steroid injection in the esophagus,oral steroid administration,radial incision and cutting(RIC).The actual efficacy of these different therapeutic options is highly variable,and uniform international standards for the prevention or treatment of stricture.CASE SUMMARY In this report,we describe the case of a 51-year-old male diagnosed with early esophageal cancer.To protect against esophageal stricture,the patient was administered oral steroids and underwent self-expandable metallic stent insertion for 45 d.Despite these interventions,stricture was detected at the lower edge of the stent following its removal.The patient remained refractory to multiple rounds of endoscopic bougie dilation treatment,and thus suffered from complex refractory benign esophageal stricture.As such,RIC combined with bougie dilation and steroid injection was employed to treat this patient more effectively,ultimately achieving satisfactory therapeutic efficacy.CONCLUSION Combination of RIC,dilation,and steroid injection can be safely and effectively implemented to treat cases of post-ESD refractory esophageal stricture.展开更多
The case variable model is put forward by analyzing the system model and the IDEFO model. The component variables of the machining system are classified into four types, I. E uncontrolled variables, process variables,...The case variable model is put forward by analyzing the system model and the IDEFO model. The component variables of the machining system are classified into four types, I. E uncontrolled variables, process variables, controlled variables and output variables. The process of building the case base is given. The high-speedcutting data base system is developed based on the presented variable model.展开更多
For solving water entry problems, a numerical method is presented, which is a CFD method based on free surface capturing method and Cartesian cut cell mesh.In this approach, incompressible Euler equations for a variab...For solving water entry problems, a numerical method is presented, which is a CFD method based on free surface capturing method and Cartesian cut cell mesh.In this approach, incompressible Euler equations for a variable density fluid are numerically calculated by the finite volume method.Then artificial compressibility method, dual time-stepping technique and Roe's approximate Riemann solver are adopted in the numerical scheme.Finally, some application cases are designed to show the ability of the current method to cope with water entry problems in ocean engineering.展开更多
文摘BACKGROUND Congenital duodenal webs are rare in adults and can lead to various symptoms such as nausea,vomiting,and postprandial fullness.The treatment for this disease is mostly surgical.Endoscopic treatment techniques have been developed and attempted for this disease.Endoscopic radial incision and cutting(RIC)techniques are reportedly very effective in benign anastomotic stricture.This case report highlights the effectiveness and safety of endoscopic RIC as a minimally invasive treatment for adult congenital duodenal webs.CASE SUMMARY A 23-year-old female patient with indigestion was referred to a tertiary hospital.The patient complained of postprandial fullness in the epigastric region.Previous physical examinations or blood tests indicated no abnormalities.Computed tomography revealed an eccentric broad-based delayed-enhancing mass-like lesion in the second portion of the duodenum.Endoscopy showed an enlarged gastric cavity and a significantly dilated duodenal bulb;a very small hole was observed in the distal part of the second portion,and scope passage was not possible.Gastrografin upper gastrointestinal series was performed,revealing an intraduodenal barium contrast-filled sac with a curvilinear narrow radiolucent rim,a typical"windsock"sign.Endoscopic RIC was performed on the duodenal web.The patient recovered uneventfully.Follow-up endoscopy showed a patent duodenal lumen without any residual stenosis.The patient reported complete resolution of symptoms at the 18-month follow-up.CONCLUSION Endoscopic RIC may be an effective treatment for congenital duodenal webs in adults.
基金Supported by The Sichuan Medical Association Digestive Endoscopy Special Committee Special Topic,China,No.2021XHNJ05。
文摘BACKGROUND Endoscopic submucosal dissection(ESD)post-procedure stricture is a relatively common long-term complication following ESD treatment.A range of approaches has been implemented for the treatment of post-procedural stricture using endoscopic techniques such as endoscopic dilation,self-expandable metallic stent insertion,local steroid injection in the esophagus,oral steroid administration,radial incision and cutting(RIC).The actual efficacy of these different therapeutic options is highly variable,and uniform international standards for the prevention or treatment of stricture.CASE SUMMARY In this report,we describe the case of a 51-year-old male diagnosed with early esophageal cancer.To protect against esophageal stricture,the patient was administered oral steroids and underwent self-expandable metallic stent insertion for 45 d.Despite these interventions,stricture was detected at the lower edge of the stent following its removal.The patient remained refractory to multiple rounds of endoscopic bougie dilation treatment,and thus suffered from complex refractory benign esophageal stricture.As such,RIC combined with bougie dilation and steroid injection was employed to treat this patient more effectively,ultimately achieving satisfactory therapeutic efficacy.CONCLUSION Combination of RIC,dilation,and steroid injection can be safely and effectively implemented to treat cases of post-ESD refractory esophageal stricture.
文摘The case variable model is put forward by analyzing the system model and the IDEFO model. The component variables of the machining system are classified into four types, I. E uncontrolled variables, process variables, controlled variables and output variables. The process of building the case base is given. The high-speedcutting data base system is developed based on the presented variable model.
基金Supported by the National 863 Plan Foundation under Grant No.2006AA09A104
文摘For solving water entry problems, a numerical method is presented, which is a CFD method based on free surface capturing method and Cartesian cut cell mesh.In this approach, incompressible Euler equations for a variable density fluid are numerically calculated by the finite volume method.Then artificial compressibility method, dual time-stepping technique and Roe's approximate Riemann solver are adopted in the numerical scheme.Finally, some application cases are designed to show the ability of the current method to cope with water entry problems in ocean engineering.
