Gastroduodenal fistül ve peptik ülser fistülizasyonu

Özet

Kronik veya derin peptik ülser, prepilorik antrum ile duodenal bulb arasında edinsel çift pilor kanalı oluşturabilir; daha seyrek olarak ülser komşu kolona ilerleyerek gastrokolik fistüle yol açar. Kontrastlı batın BT, duvar defekti ve komşu inflamasyonu ararken oral kontrast kullanılmışsa lümenler arası geçişi doğrudan gösterebilir; küçük traktlar BT'de görünmeyebilir. Posterior duodenal ülser retroperitoneuma penetre olabilir veya pankreas gibi komşu organlara fistülize olabilir; bunlar ayrı komplikasyonlardır. Gastrokolik fistüller geç tanınabilir; kusma, ishal ve kilo kaybıyla başvurabilir ve malnütrisyon, vitamin eksiklikleri, elektrolit bozuklukları veya sepsisle ilişkili olabilir; maligniteye bağlı fistül, gecikmiş tümör saptanmasıyla ortaya çıkabilir.

Okuma sırası

1. Prepilorik antrum ve duodenal bulb. Koronal planda mide çıkışını bul ve prepilorik antrumun duodenal bulb ile normal tek kanallı bağlantısını izle; ikinci bir açıklık olup olmadığını araştır.
2. Ülser krateri ve trakt. Antrum veya bulb duvarındaki fokal kraterin komşu organa doğru kesintisiz uzanıp uzanmadığını ardışık kesitlerde takip et.
3. Fistül içeriği. Oral kontrast kullanılmışsa opak maddenin kaynak lümenden diğer lümene geçtiği kesiti göster; kontrast yoksa gaz ve yumuşak doku devamlılığını doğrula.
4. Transvers kolon ve pankreas komşuluğu. Mide ile transvers kolon arasındaki komşuluğu ve varsa oral kontrastın iki lümen arasındaki geçişini inceleyerek fistülü araştır; posterior duodenal ülserin retroperitoneuma penetrasyonunu, pankreas gibi komşu organlara fistülizasyondan ayrı değerlendir.
5. Fistül çevresi ve komşu organlar. Son olarak çevredeki koleksiyonu, serbest havayı, peritoneal sıvıyı ve düzensiz kitle ya da lenf nodu gibi malignite işaretlerini tara.

Faz ve pencere

Portal tanısal

Portal venöz fazda prepilorik antrum veya proksimal duodenumda ülser krateri, fokal duvar kalınlaşması ve komşu yağ dokusunda inflamatuvar çizgilenme değerlendirilebilir; duvar kalınlaşması ve mukozal hiperenhansman arteriyel-dominant veya pankreatik fazlarda daha belirgindir. Oral kontrast verilmişse diğer lümende kontrast görülmesi fistül geçişini destekler; BT’de traktın gösterilememesi fistülü tek başına dışlamaz.

Önerilen pencereler: Batın (G 400 / M 50), Yumuşak doku (G 400 / M 40).

BT bulguları

• Prepilorik antrum ile duodenal bulb arasında normal pilor kanalına ek, ince ve epitelize görünümlü ikinci geçiş kanalı (edinsel çift pilor paterni)
• Antrum veya duodenal bulb duvarında fokal ülser krateri, duvar süreksizliği ve komşu yağ dokuda çizgilenme
• Ülser yatağından duodenal bulb ya da mide antrumuna uzanan kısa, gaz veya oral kontrast içeren fistül traktı
• Mide büyük kurvaturu ile transvers kolon arasında silinmiş yağ planı, inflamatuvar yumuşak doku bandı veya doğrudan duvar devamlılığı
• Oral kontrastın mide lümeninden transvers kolon lümenine geçmesi ya da kontrastlı kolonda mideye ait içerik görülmesi
• Posterior duodenal ülser retroperitoneuma penetre olabilir veya pankreas gibi komşu organlara fistülize olabilir; bunlar ayrı komplikasyonlardır.
• Fistül çevresinde gaz içeren koleksiyon, duvar kalınlaşması veya yaygın yağ dokusu inflamasyonu
• Düzensiz kitle benzeri duvar kalınlaşması ve bölgesel lenf nodları gibi altta yatan maligniteyi düşündüren eşlikçiler

Normalde

Normal mide piloru ile duodenal bulb arasında yalnız tek lümenli pilor kanalı bulunur; prepilorik antrum ve bulb duvar konturları süreklidir. Mide büyük kurvaturu ile transvers kolon arasında yağ planı ve ayrı duvar konturları seçilir; oral kontrast yalnız opaklaştırdığı lümende kalır, pankreasla aradaki yağ planı korunur.

Ayırıcı tanı

Penetran peptik ülser

derin krater pankreas ya da komşu yağ dokusuna ulaşır, fakat iki epitelize lümen arasında açıklık veya kontrast geçişi gösterilemeyebilir.

Perfore peptik ülserde serbest hava veya sıvı, bağırsak duvarında süreksizlik ve çevre yağ dokusunda çizgilenme görülebilir; komşu bağırsak lümenine kontrast geçişi perforasyon tanımı için gerekli değildir.

Gastroduodenal malignitede duvar kalınlaşması ülserle örtüşebilir; fokal, nodüler veya kitle biçimli kalınlaşma ve çevre yağ dokusuna infiltrasyon maligniteyi düşündürür, tanının doğrulanması için genellikle endoskopi gerekir.

Crohn hastalığı

segmental bağırsak duvar kalınlaşması, skip alanlar ve birden çok enterik fistül eşlik edebilir; izole ülserli antrum odağı tipik değildir.

Tuzaklar

• Posterior duodenal ülser retroperitoneuma penetre olabilir veya pankreas gibi komşu organlara fistülize olabilir; bu iki bulgu ayrı değerlendirilmelidir.
• Oral kontrastsız BT'de gastrokolik trakt yalnız ince yumuşak doku bandı ya da gaz çizgisi olarak kalabilir; negatif inceleme fistülü dışlamaz.
• İnflamatuvar duvar kalınlaşması ile malignite ayrımında, fokal, nodüler veya kitle biçimli kalınlaşma ve çevre yağ dokusuna infiltrasyon maligniteyi düşündürür; BT görünümleri örtüşebildiğinden tanının doğrulanması için genellikle endoskopi gerekir.
• Tek aksiyel kesitte üst üste gelen mide ve kolon lümenleri fistül değildir; koronal/sagittal devamlılığı veya oral kontrast geçişini doğrula.

Kendini dene

1. Prepilorik ülserden duodenal bulb'a ikinci, kontrastlanan bir kanal uzanıyor. En olası tanı nedir?

   • Edinsel çift pilor
   • Pilor stenozu
   • Gastroözofageal bileşke tümörü
   • Pankreas psödokisti
   Cevabı göster

   Edinsel çift pilor. Peptik ülserle ilişkili antrum-bulb arasında ikinci kanal edinsel çift pilor görünümüdür. Stenoz tek daralmış çıkış yapar; bileşke tümörü bu seviyede değildir; psödokist mide duvarından duodenuma kanal oluşturmaz.

2. Oral kontrast mide lümeninden transvers kolona geçiyor ve arada ülserli duvar defekti var. Hangi bağlantı gösterilmiştir?

   • Gastrokolik fistül
   • Duodenal divertikül
   • Pankreatik psödokist
   • İnce bağırsak obstrüksiyonu
   Cevabı göster

   Gastrokolik fistül. Mide içindeki oral kontrastın doğrudan transvers kolon lümenine ulaşması gastrokolik iletiyi destekler. Divertikül duodenumdan kör kese şeklinde çıkar; psödokist koleksiyondur; obstrüksiyon lümenler arası kontrast geçişi oluşturmaz.

Kaynaklar

Bu sayfadaki 38 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla tek tek karşılaştırıldı; 10 cümle bu karşılaştırmada düzeltildi (2026-10-09).

1. Non-perforated peptic ulcer disease: multidetector CT findings, complications, and differential diagnosispmc.ncbi.nlm.nih.gov
2. Benign Peptic Ulcer as a Cause of Gastrocolic Fistulapmc.ncbi.nlm.nih.gov
3. Gastrocolic Fistula: An Extraordinary Gastrointestinal Fistulapmc.ncbi.nlm.nih.gov
4. Initial case of spontaneous gastrocutaneous fistula following nonsteroidal antiinflammatory drug treatment: a case reportpmc.ncbi.nlm.nih.gov
5. Emergency Endovascular Aneurysm Repair for Aortoduodenal Fistula After Interposition Tube Graft: Initial Damage Control Surgery at a Primary Care Hospitalpmc.ncbi.nlm.nih.gov
6. Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.pubmed.ncbi.nlm.nih.gov
7. Radiologic Interventions for Gastrointestinal Bleeding.pubmed.ncbi.nlm.nih.gov
8. Radiological Assessment After Pancreaticoduodenectomy for a Precision Approach to Managing Complications: A Narrative Review.pubmed.ncbi.nlm.nih.gov
9. Diagnostic Value of Multimodal Imaging and Histopathology in Gallstone Ileus: A Retrospective Analysis.pubmed.ncbi.nlm.nih.gov
10. Topographic and Anatomical Landmarks of Key Points in Embryologically Guided Surgery for Locally Advanced Gastric Cancer Using Computer-Assisted 3D Navigation.pubmed.ncbi.nlm.nih.gov
11. Fishbone ingestion is a non-negligible cause of intestinal perforation.pubmed.ncbi.nlm.nih.gov
12. Evolution of imaging for abdominal perforation.pubmed.ncbi.nlm.nih.gov
13. Management of Complications After Pancreaticoduodenectomy: A Narrative Review of Pathophysiology and Treatment Strategies.pubmed.ncbi.nlm.nih.gov
14. Cross-sectional imaging after pancreatic surgery: The dialogue between the radiologist and the surgeon.pubmed.ncbi.nlm.nih.gov
15. Conference Proceedings: Select Abstracts Presented at the 2025 Advocate Aurora Scientific Day.pubmed.ncbi.nlm.nih.gov
16. Double pylorus in an elderly female patient: a case report.pubmed.ncbi.nlm.nih.gov
17. Stricturing Diseases of the Gastrointestinal Tract-Current Clinical Practice.pubmed.ncbi.nlm.nih.gov
18. Prevalence of Abnormalities at Tandem Endoscopy in Patients Referred for Colorectal Cancer Screening/Surveillance Colonoscopy.pubmed.ncbi.nlm.nih.gov
19. Cross-sectional imaging features of duodenal obstruction: A case series highlighting etiologic diversity.pubmed.ncbi.nlm.nih.gov
20. Exploring the neglected segment of the intestine: the duodenum and its pathologies.pubmed.ncbi.nlm.nih.gov
21. Navigating the Complexities of Radiation Injuries: Therapeutic Principles and Reconstructive Strategies.pubmed.ncbi.nlm.nih.gov
22. Evidence-based, cost-effective management of gastric outlet obstruction: An algorithm of the Journal of Trauma and Acute Care Surgery , Emergency General Surgery Algorithms Work Group.pubmed.ncbi.nlm.nih.gov
23. Emergency Endovascular Aneurysm Repair for Aortoduodenal Fistula After Interposition Tube Graft: Initial Damage Control Surgery at a Primary Care Hospital.pubmed.ncbi.nlm.nih.gov
24. Hemorrhage, Fistulization, and Rupture: Management of a Cascade of Complications from a Single Pancreatic Pseudocyst.pubmed.ncbi.nlm.nih.gov
25. A Case of Gastrocolic Cutaneous Fistula in a Patient With Crohn's Disease.pubmed.ncbi.nlm.nih.gov
26. Anastomotic-Transverse Colon Fistula Following Gastrectomy: A Case Report of Delayed Diagnosis 14 Years After Surgery.pubmed.ncbi.nlm.nih.gov
27. Jejunocecal fistula combined with gastro-ascending colonic fistula in a child with chronic diarrhea and weight loss: a case report.pubmed.ncbi.nlm.nih.gov
28. Novel minimally invasive management of gastric-diaphragmatic-pleural-bronchial fistula following sleeve gastrectomy: a case report.pubmed.ncbi.nlm.nih.gov
29. Cholecystogastric fistula masquerading as gastrointestinal stromal tumour: Unusual presentation of gallbladder adenomyomatosis - a case report.pubmed.ncbi.nlm.nih.gov
30. Communicating bronchopulmonary foregut malformations: Revisiting a rare entity.pubmed.ncbi.nlm.nih.gov
31. Choledochoduodenal fistula paradoxically prevents biliary obstruction: a case report.pubmed.ncbi.nlm.nih.gov
32. Case Report: Sphincter-preserving surgery after conversion therapy and longitudinal recovery of bowel function in ultra-low rectal cancer.pubmed.ncbi.nlm.nih.gov
33. The vagus nerve as a neurovisceral interface: a comprehensive review.pubmed.ncbi.nlm.nih.gov
34. Multifocal cellulitis and polymicrobial infection in a patient with a perforated duodenal ulcer: a case report and literature review.pubmed.ncbi.nlm.nih.gov
35. Jejunal Diverticulitis With Contained Perforation and Abscess Successfully Managed With Conservative Therapy: A Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
36. Perforated Duodenal Ulcer in the Immediate Postpartum Period: Diagnostic Pitfalls Following Caesarean Delivery.pubmed.ncbi.nlm.nih.gov
37. Hiding in Plain Sight: A Case of Intestinal Tuberculosis Masquerading as Benign Lower GI Bleeding.pubmed.ncbi.nlm.nih.gov
38. The hidden path of mycobacterium: a case series of rare and elusive manifestations of gastrointestinal tuberculosis.pubmed.ncbi.nlm.nih.gov
39. Bacterial Granulomatous Lung Diseases: Radiological Findings and Differential Diagnosis.pubmed.ncbi.nlm.nih.gov
40. Gastric Outlet Obstruction from Brunner Gland Hyperplasia Mimicking Malignancy: A Case Report.pubmed.ncbi.nlm.nih.gov
41. Diagnostic and therapeutic challenges with malignant biliary tract and periampullary pathology in post-bariatric surgery.pubmed.ncbi.nlm.nih.gov
42. Left-sided compartmental resection of an 18 kg retroperitoneal liposarcoma: a case report.pubmed.ncbi.nlm.nih.gov
43. Pancreaticoduodenectomy for Ampullary Carcinoma after Clinical Resolution of Necrotizing Pancreatitis with Giant Walled-Off Necrosis: A Case Report.pubmed.ncbi.nlm.nih.gov
44. Comprehensive Computed Tomography Evaluation of Gastric Cancer: 2026 Consensus Recommendation From the Korean Society of Abdominal Radiology.pubmed.ncbi.nlm.nih.gov
45. Extravertebral low back pain: a scoping review.pubmed.ncbi.nlm.nih.gov
46. Indian guidelines on imaging of the small intestine in Crohn's disease: A joint Indian Society of Gastroenterology and Indian Radiology and Imaging Association consensus statement.pubmed.ncbi.nlm.nih.gov
47. Magnetic resonance imaging of pancreatitis: an update.pubmed.ncbi.nlm.nih.gov
48. Review of Peptic Ulcer Disease: Insights from Pathophysiology, Mechanisms, Pharmacotherapy, Phytotherapy, and Case Reports.pubmed.ncbi.nlm.nih.gov
49. Diagnostic Challenges and Management of Blunt Traumatic Duodenal Diverticulum Perforation: A Systematic Review.pubmed.ncbi.nlm.nih.gov
50. Gastrointestinal Fistulas-What Gastroenterologists Need to Know in 2025.pubmed.ncbi.nlm.nih.gov
51. Exophytic colonic carcinoma complicated by gastrocolic fistula mimicking a giant gastric mass: a case report and brief review.pubmed.ncbi.nlm.nih.gov
52. Octreotide as A Bridge to Anti-TNF Therapy in Severe Fistulizing Crohn's Disease Complicated by A Clinically High-Output Enterocutaneous Fistula: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
53. An unusual cause of a vesical mass: Small bowel diverticulum presenting with a bladder fistula: A case report and review of the literature.pubmed.ncbi.nlm.nih.gov
54. Clinical and radiologic predictors of one-year surgical outcomes in Crohn's disease-related intra-abdominal abscesses.pubmed.ncbi.nlm.nih.gov
55. Beyond the Six-Week Rule: Contemporary Insights Into Pancreatic Pseudocyst.pubmed.ncbi.nlm.nih.gov
56. Pancreatic Pseudocysts: A Retrospective Comparative Study of Contemporary Management Strategies at a Tertiary Care Centre in Central India.pubmed.ncbi.nlm.nih.gov
57. Coexistence of Autoantibodies against the Golgi Complex and Ro52 Antigen in a Patient with Nonspecific Interstitial Pneumonia.pubmed.ncbi.nlm.nih.gov
58. Long-term safety and effectiveness of the "OptEase" vena cava filter.pubmed.ncbi.nlm.nih.gov
59. Discordance between CECT and angiographic findings in severe acute pancreatitis-related hemorrhage: implications for interventional management.pubmed.ncbi.nlm.nih.gov
60. The Overlap Between Crohn's Disease and Intestinal Tuberculosis: A Never-Ending Story.pubmed.ncbi.nlm.nih.gov
61. Iron and Other Metal Ions in Human Health and Disease.pubmed.ncbi.nlm.nih.gov
62. Diagnostic value of endoscopic ultrasound in groove pancreatitis.pubmed.ncbi.nlm.nih.gov
63. Radiological investigation of acute mandibular injury.pubmed.ncbi.nlm.nih.gov
64. Imaging in Third Molar Surgery: A Clinical Update.pubmed.ncbi.nlm.nih.gov
65. The butterfly effect: improving brain cone-beam CT image artifacts for stroke assessment using a novel dual-axis trajectory.pubmed.ncbi.nlm.nih.gov
66. Persistent Gastrointestinal Bleeding after Aortic Valve Replacement in Heyde's Syndrome.pubmed.ncbi.nlm.nih.gov
67. Stress-sensitive neural circuits change the gut microbiome via duodenal glands.pubmed.ncbi.nlm.nih.gov
68. Advances in Pediatric Diagnostic Endoscopy: A State-of-the-Art Review.pubmed.ncbi.nlm.nih.gov
69. Individualized Stent for Tracheal Fistula Complicating Tracheostomy Following Esophagectomy.pubmed.ncbi.nlm.nih.gov
70. Delayed Constrictive Pericarditis Following Presumed Esophagopericardial Communication After Esophageal Stenting.pubmed.ncbi.nlm.nih.gov
71. Multimodal imaging in neuro-ophthalmology.pubmed.ncbi.nlm.nih.gov
72. Duropathies as Unifying Concept-Part Two: A Narrative Overview of Clinical and Neuroradiological Features.pubmed.ncbi.nlm.nih.gov
73. Advances in Image-Guided Ablation Therapies for Solid Tumors.pubmed.ncbi.nlm.nih.gov
74. Is It Time to Abandon the Absolute Contraindication to FNAC in Pulmonary Hydatid Cysts? A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
75. Acute left ovarian vein thrombosis following percutaneous renal biopsy: A case report.pubmed.ncbi.nlm.nih.gov
76. The illusion of malignancy: a rare case of post-hysterectomy gossypiboma misinterpreted as ovarian cancer.pubmed.ncbi.nlm.nih.gov
77. Double pylorus: a case report and review of the literature.pubmed.ncbi.nlm.nih.gov
78. Congenital Antral Web Presenting as Gastric Outlet Obstruction in Adulthood: A Case Report.pubmed.ncbi.nlm.nih.gov
79. An Uncommon Adverse Event of Endoscopic Vacuum Therapy and Pigtail Stent Placement for the Treatment of Bariatric Surgery Leak.pubmed.ncbi.nlm.nih.gov
80. Gastrocolic fistula in a patient with gastrointestinal tuberculosis: a case report from Nepal, a tuberculosis endemic region.pubmed.ncbi.nlm.nih.gov
81. Stent-bridging fistulogastrostomy for refractory post-pancreatectomy external pancreatic fistula.pubmed.ncbi.nlm.nih.gov
82. A rare case of upper gastrointestinal hemorrhage due to tuberculous lymphadenitis fistulized in the duodenum.pubmed.ncbi.nlm.nih.gov
83. Massive gastrointestinal hemorrhage and iodine-125 seed migration due to hepatogastric fistula: a case report and literature review.pubmed.ncbi.nlm.nih.gov
84. Arterial and biliary complications after transarterial chemoembolization for hepatocellular carcinoma.pubmed.ncbi.nlm.nih.gov
85. Hemosuccus Pancreaticus from Large Inferior Pancreaticoduodenal Artery Pseudoaneurysm Complicating Chronic Pancreatitis.pubmed.ncbi.nlm.nih.gov
86. Seasonal Variation of Presentation of Perforated Peptic Ulcer Disease: An Overview of Patient Demographics, Management and Outcomes.pubmed.ncbi.nlm.nih.gov
87. Non-perforated peptic ulcer disease: multidetector CT findings, complications, and differential diagnosis.pubmed.ncbi.nlm.nih.gov
88. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections.pubmed.ncbi.nlm.nih.gov
89. Imaging of intestinal vasculitis focusing on MR and CT enterography: a two-way street between radiologic findings and clinical data.pubmed.ncbi.nlm.nih.gov
90. Chronic Pancreatitis: Role of Endoscopic Procedures.pubmed.ncbi.nlm.nih.gov
91. Clinical, Radiological, and Endoscopic Features of Pancreatic Pseudocyst and Walled-Off Necrosis: How to Diagnose and How to Drain Them.pubmed.ncbi.nlm.nih.gov
92. A Practical Approach in Differentiating IBD From Other Causes of Enterocolitis.pubmed.ncbi.nlm.nih.gov
93. Etiology, diagnosis, and management of chronic pancreatitis associated primary complications: a narrative review.pubmed.ncbi.nlm.nih.gov
94. Guidelines for endoscopic treatment of postinflammatory pancreatic and peripancreatic fluid collections. Recommendations of the Endoscopic Surgery Section of the Association of Polish Surgeons, the Endoscopy Section of the Polish Society of Gastroenterology, the Polish Pancreatic Club, the Laparoscopic and Robotic Surgery Section of the Association of Polish Surgeons, and the Pancreatic Surgery Section of the Association of Polish Surgeons; formulated by an expert panel led by Prof. Mateusz Jagielski, MD, PhD.pubmed.ncbi.nlm.nih.gov
95. Endoscopic Ultrasound-Guided Lumen-Apposing Metal Stent Drainage in Benign Pancreatobiliary and Gastrointestinal Disease: Evolving Techniques and Clinical Outcomes.pubmed.ncbi.nlm.nih.gov
96. Role of Endoscopic Ultrasound-guided Gastroenterostomy for Benign Gastric Outlet Obstruction.pubmed.ncbi.nlm.nih.gov
97. Two case reports of mesenteric and retroperitoneal actinomycosis and a narrative review of the relevant literature.pubmed.ncbi.nlm.nih.gov
98. Fulminant <i>Clostridioides difficile</i> pseudomembranous colitis requiring subtotal colectomy after pancreaticoduodenectomy: A case report and mini-review.pubmed.ncbi.nlm.nih.gov
99. A rare cause of acute esophageal necrosis: A case report.pubmed.ncbi.nlm.nih.gov
100. Arteriogenic hemorrhage of the anastomotic loop after choledochojejunostomy: case series and literature review.pubmed.ncbi.nlm.nih.gov
101. Telling Ghost Stories Around a Bonfire-A Literature Review of Acute Bleeding Secondary to Pancreatitis.pubmed.ncbi.nlm.nih.gov
102. Three Types of Collateral Arterial Supply to the Spleen After Spleen-Preserving Distal Pancreatectomies with Splenic Vessels Resection-How to Use This Knowledge for Organ(s) Preservation in Locally Advanced and Borderline Resectable Pancreatic Head Cancers Surgery-Hemodynamic, Surgical and Oncological Outcomes of 134 Spleen-Preserving Pancreatectomies.pubmed.ncbi.nlm.nih.gov
103. Oral and upper gastrointestinal Crohn's disease: new perspectives on pathogenesis and clinical management.pubmed.ncbi.nlm.nih.gov
104. Endovascular intervention and risk factor assessment for postoperative pseudoaneurysms after pancreatic surgery: a 9-year retrospective study.pubmed.ncbi.nlm.nih.gov
105. Gallstone Ileus After Conservative Management of Acute Cholecystitis and Refusal of Interval Cholecystectomy: A Case Report.pubmed.ncbi.nlm.nih.gov
106. Evaluation of predictive factors for morbidity and mortality in patients undergoing surgery for peptic ulcer perforation.pubmed.ncbi.nlm.nih.gov
107. Sigmoid pneumatosis cystoides intestinalis secondary to chronic digestive hyperpressure on post-ulcer duodenal bulb stenosis, decompensated following recent endoscopic insufflation.pubmed.ncbi.nlm.nih.gov
108. Duodenal tuberculosis with probable biliary involvement in primary Sjögren's syndrome mimicking pancreatobiliary malignancy: a case report.pubmed.ncbi.nlm.nih.gov
109. Perforated Gastric Cancer: Epidemiology, Diagnosis, and Surgical Management Strategies.pubmed.ncbi.nlm.nih.gov
110. Diffuse Large B-Cell Lymphoma Masquerading as Recurrent Pleural Effusion and Melena: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
111. Rare case report and literature review of peripheral T-cell lymphoma presenting as massive gastrointestinal hemorrhage: an unusual etiology demanding emergency surgical intervention.pubmed.ncbi.nlm.nih.gov
112. A Case of Intracholecystic Papillary Neoplasm Extending Through a Cholecysto-Colonic Fistula.pubmed.ncbi.nlm.nih.gov
113. A case series of emergency pancreaticoduodenectomies: What were their indications and outcomes?pubmed.ncbi.nlm.nih.gov
114. How far is the endoscopist to blame for a percutaneous endoscopic gastrostomy complication?pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez. İçerik yapay zekâ destekli bir süreçle güncel literatüre göre cümle cümle kaynaklarla karşılaştırıldı, ancak uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.