2,983 results match your criteria Whipple Disease


Pancreaticoduodenal Groove: Spectrum of Disease and Imaging Features.

Radiographics 2022 May 20:210168. Epub 2022 May 20.

From the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Emory University Hospital, 1365-A Clifton Rd NE, Suite AT-627, Atlanta, GA 30322 (H.R.B., A.S., A.H.D.); Department of Radiology, MedStar Georgetown University Hospital, Washington, DC (R.W.F.); and Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (A.R.R.).

The pancreaticoduodenal groove (PDG) is a small space between the pancreatic head and duodenum where vital interactions between multiple organs and physiologic processes take place. Muscles, nerves, and hormones perform a coordinated dance, allowing bile and pancreatic enzymes to aid in digestion and absorption of critical nutrition. Given the multitude of organs and cells working together, a variety of benign and malignant entities can arise in or adjacent to this space. Read More

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Longitudinal Correlates of Increased Alcohol Use Among Adolescents and Young Adults During the COVID-19 Pandemic.

Alcohol Alcohol 2022 Apr 30. Epub 2022 Apr 30.

Department Psychiatry and Psychology, Mayo Clinic Health System, 1221 Whipple St., Eau Claire, WI, 54703, USA.

Aims: The objective of this study is to longitudinally assess sociodemographic and psychological correlates of increased alcohol use during the coronavirus disease of 2019 (COVID-19) period among adolescents and young adults.

Methods: Pre-COVID period is defined as the 1-year period on or before 31 March 2020, and during-COVID period is defined as the period from 1st April 2020 to 30 March 2021. Univariable logistic regression models are used to evaluate the association of demographic characteristics, Area Deprivation Index (ADI), rurality, changes in Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scale severity, and the risk of increased alcohol consumption (binge drinking, number of drinks and drinking regularity) from pre-COVID to during-COVID period. Read More

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Potentially curative resection of an abdominal wall metastasis from pancreatic adenocarcinoma: a case report.

J Surg Case Rep 2022 Apr 26;2022(4):rjac138. Epub 2022 Apr 26.

The Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA.

Pancreatic cancer has a low survival rate even after ostensible complete resection, and treatment for recurrence is usually only palliative. However, rare solitary metastasis can occur and may be operable. In this report, we describe such a case and review the literature on metastasectomy for pancreatic adenocarcinoma. Read More

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Central Nervous System Whipple Disease Presenting as Hypersomnolence.

Cureus 2022 Mar 28;14(3):e23572. Epub 2022 Mar 28.

Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, USA.

Whipple disease (WD) is a rare systemic infection caused by . Its clinical features are broad, and atypical clinical patterns such as the involvement of the heart, lungs, or the central nervous system (CNS) can occur. We report a case of a 58-year-old man who had been previously diagnosed with classic WD; he was evaluated for functional decline, extreme somnolence, and recurrent admissions for hydrocephalus. Read More

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Intestinal barrier dysfunction mediates Whipple's disease immune reconstitution inflammatory syndrome (IRIS).

Immun Inflamm Dis 2022 May;10(5):e622

Medical Department I, Gastroenterology, Infectious Diseases and Rheumatology, Charité-University Medicine, Berlin, Germany.

Background & Aims: Classical Whipple's disease (CWD) affects the gastrointestinal tract and causes chronic diarrhea, malabsorption, and barrier dysfunction with microbial translocation (MT). Immune reconstitution inflammatory syndrome (IRIS) is a serious complication during antimicrobial treatment of CWD. The pathomechanisms of IRIS have not been identified and mucosal barrier integrity has not been studied in patients with IRIS CWD. Read More

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Preoperative Endoscopic Ultrasound-Guided Hepaticogastrostomy Facilitates Decompression and Diagnosis in Patients With Suspected Malignant Biliary Obstruction: A Case Series.

Cureus 2022 Mar 16;14(3):e23209. Epub 2022 Mar 16.

Gastroenterology, Atrium Health Wake Forest Baptist, Winston-Salem, USA.

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HG) is increasingly being used as an alternative to percutaneous transhepatic biliary drainage (PTBD) after unsuccessful endoscopic retrograde pancreatography (ERCP). This technique has also been utilized for diagnosis of malignant biliary obstruction by providing biliary access for antegrade cholangioscopy with biopsies and brushings for cytology and fluorescent in situ hybridization (FISH). However, the potential impact of EUS-HG on surgical candidacy in cases with resectable disease remains unknown. Read More

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The impact of pylorus preservation on the development of nonalcoholic fatty liver disease after pancreaticoduodenectomy: A historical cohort study.

J Hepatobiliary Pancreat Sci 2022 Apr 18. Epub 2022 Apr 18.

Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background/purpose: The pathophysiology and associated factors of nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD) remain elusive. We aimed to investigate these factors, including the operation type, for NAFLD development after PD.

Methods: This historical cohort study included 786 consecutive patients treated with either classic Whipple operation or pylorus-preserving pancreaticoduodenectomy (PPPD) in Korea between 2012 and 2018. Read More

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Endoscopic ultrasound-guided drainage using LAMS of malignant afferent limb syndrome in patients with previous Whipple surgery: A multicenter study (with video).

Dig Endosc 2022 Apr 16. Epub 2022 Apr 16.

Department of Gastroenterology. University of Paris. Georges-Pompidou European Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.

Objectives: Endoscopic ultrasound-guided digestive anastomosis (EUS-A) is a new alternative under evaluation in patients presenting with afferent limb syndrome (ALS) after Whipple surgery. The aim of the present study is to analyze the safety and effectiveness of EUS-A in ALS.

Methods: This is an observational multicenter study. Read More

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Selection of parenchymal preserving or total pancreatectomy with/without islet cell autotransplantation surgery for patients with chronic pancreatitis.

Pancreatology 2022 May 6;22(4):472-478. Epub 2022 Apr 6.

Department of Gastroenterology, University of North Carolina, Chapel Hill, NC, USA.

Background: The selection of surgery between parenchymal preserving (PPS) and total pancreatectomy (TP) with/without islet cell autotransplantation (IAT) for chronic pancreatitis (CP) patients varies based on multiple factors with a scarcity in literature addressing both at the same time. The aim of this manuscript is to present an algorithm for the surgery selection based on dominant area of disease, ductal dilatation, and glycemic control and compare outcomes.

Methods: From 2017 to 2021, CP patients offered surgery at a single institution were retrospectively evaluated. Read More

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Entrectinib in children and young adults with solid or primary CNS tumors harboring NTRK, ROS1 or ALK aberrations (STARTRK-NG).

Neuro Oncol 2022 Apr 8. Epub 2022 Apr 8.

St. Jude Children's Research Hospital, Memphis, TN, USA.

Background: Entrectinib is a TRKA/B/C, ROS1, ALK tyrosine kinase inhibitor approved for treatment of adults and children aged ≥12 years with NTRK fusion-positive solid tumors and adults with ROS1 fusion-positive non-small cell lung cancer. We report analysis of the STARTRK-NG trial, investigating the recommended phase 2 dose (RP2D) and activity of entrectinib in pediatric patients with solid tumors including primary central nervous system tumors.

Methods: STARTRK-NG (NCT02650401) is a phase 1/2 trial. Read More

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Evaluation of the latent tuberculosis care cascade among public health clinics in the United States.

Clin Infect Dis 2022 Apr 1. Epub 2022 Apr 1.

Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA.

Background: Tuberculosis (TB) elimination within the United States (US) will require scaling up TB preventive services. Many public health departments offer care for latent tuberculosis infection (LTBI), though gaps in the LTBI care cascade are not well quantified. An understanding of these gaps will be required to design targeted public health interventions. Read More

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Whipple's disease: a case report in Santa Catarina, Brazil.

Infez Med 2022 1;30(1):139-142. Epub 2022 Mar 1.

Hospital Universitário Santa Terezinha (HUST) da Universidade do Oeste de Santa Catarina (UNOESC), Joaçaba, Brazil.

Whipple's disease is a rare systemic infection caused by a diastase-resistant and Gram-positive bacillus called . The diagnosis of the disease is difficult and often late due to the variety of the symptoms. The objective of this study was to report a rare case of Whipple's disease treated at the Internal Medicine service of a hospital in the Midwest of Santa Catarina, Brazil. Read More

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Chimney Graft Preservation of Inferior Mesenteric Artery during Endovascular Repair of Aortoiliac Occlusive Atherosclerotic Disease.

J Vasc Interv Radiol 2022 Mar 24. Epub 2022 Mar 24.

Department of Vascular Surgery, Mayo Clinic Health Systems in Eau Claire, 1221 Whipple St, Eau Claire, WI, 54703.

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Pancreatoduodenectomy for monomorphic epitheliotropic intestinal T-cell lymphoma with duodenal obstruction.

BMJ Case Rep 2022 Mar 22;15(3). Epub 2022 Mar 22.

Division of Surgical Oncology, Department of Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA

We report an unusual case of a woman in her 60s diagnosed with monomorphic epitheliotropic intestinal T-cell lymphoma who required a pancreatoduodenectomy (Whipple procedure) for duodenal obstruction. The patient was initially treated with several cycles of chemotherapy, with persistent disease of the duodenum at D3. She was symptomatic with obstructive symptoms and positron emission tomography (PET)-CT showed disease localised to the duodenum without evidence of active disease elsewhere. Read More

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Endoscopic diagnosis of Whipple disease in a patient without gastrointestinal symptoms: A case report.

DEN open 2022 Apr 1;2(1):e37. Epub 2021 Sep 1.

Second Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka Japan.

Whipple's disease is a systemic chronic bacterial infection caused by , a gram-positive bacillus. infection in the small intestine often causes malabsorption and is often accompanied by gastrointestinal symptoms such as diarrhea and abdominal pain. In this report, we describe our experience with a case of Whipple's disease in which the affected patient did not have the typical gastrointestinal symptoms. Read More

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Tropheryma whipplei in the stool samples of children with acute diarrhea: a study from Tehran, Iran.

BMC Infect Dis 2022 Feb 27;22(1):193. Epub 2022 Feb 27.

National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, Kabudar Ahang, Hamadan, Iran.

Background: Recently, Tropheryma whipplei has been suggested as one of the causative agents of diarrhea among children worldwide. Limited data is available on the prevalence of T. whipplei among children with diarrhea in most countries such as Iran. Read More

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February 2022

Subcutaneous Nodules Caused by Tropheryma whipplei Infection.

Emerg Infect Dis 2022 Mar;28(3):761-763

To help clarify the clinical manifestations, diagnosis, and treatment for Whipple disease, we report a case of a man in China infected with Tropheryma whipplei. The patient had multiple subcutaneous nodules as the only manifestation, which was not consistent with the typical symptoms of T. whipplei infection. Read More

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Whipple's disease - a rare and challenging complication in a patient with Crohn's disease.

Z Gastroenterol 2022 Apr 17;60(4):598-601. Epub 2022 Feb 17.

Gastroenterology and Hepatology, Max Grundig Clinic, Bühl/Baden, Bühl, Germany.

Introduction: Whipple's disease (WD) is a rare and infectious condition leading to multi-organ impairment caused by Tropheryma whipplei (TW), a ubiquitously occurring bacterium. TW can be detected in tissues by histological detection of PAS ("periodic acid-ship reaction")-positive macrophages and by polymerase-chain-reaction (PCR). Clinically, WD is often characterized by diarrhea, abdominal pain, and weight loss. Read More

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Recurrent thrombosis as a clinical presentation of Whipple disease.

BMJ Case Rep 2022 Feb 10;15(2). Epub 2022 Feb 10.

Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain.

Whipple's disease (WD) is a rare infectious disease with a wide clinical spectrum. Associated thrombotic manifestations are not well described in WD, only related to 'stroke-like syndrome'. We present a case of a 39-year-old man with a 1-year history of self-limited episodes of fever, associated with generalised adenopathies and recurrent superficial and deep venous thrombosis events, which have resorted four times despite the anticoagulant treatment. Read More

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February 2022

Whipple Disease: An Atypical Diagnosis by Capsule Endoscopy in an Oldest-Old Patient.

GE Port J Gastroenterol 2022 Jan 19;29(1):61-63. Epub 2021 Mar 19.

Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

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January 2022

Challenging case of Whipple's disease: The contribution of radiology.

Radiol Case Rep 2022 Mar 22;17(3):1008-1012. Epub 2022 Jan 22.

Department of Radiology, Champalimaud Foundation, Avenida de Brasília, Lisboa 1400-038, Portugal.

Whipple's disease is a rare chronic infectious disease, caused by . The disease can be challenging to diagnose due to the variable clinical manifestations and the nonspecific laboratory and imaging findings. We report the case of a 75-year-old man, complaining of weight loss and arthralgias with an insidious onset. Read More

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Impact of COVID-19 on pancreatic cancer surgery: A high-volume Polish center experience.

Adv Clin Exp Med 2022 Apr;31(4):389-398

Department of Gastroenterological Surgery and Transplantology, Center of Postgraduate Medical Education in Warsaw, Poland.

Background: A total of 148 surgeries were performed in our center on patients with pancreatic cancer in 2020. In 2019, 263 such procedures were performed (77.7% more) in this facility. Read More

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Aggressive Papillary Thyroid Carcinoma Presenting with Metastasis to the Pancreas.

Case Rep Endocrinol 2022 20;2022:5355419. Epub 2022 Jan 20.

Division of Endocrinology, Diabetes, and Metabolism, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA.

Papillary thyroid cancer is the most common type of thyroid cancer. Aggressive forms tend to metastasize to the lungs and bones, but the abdomen is a rare site of metastasis. We present a 46-year-old male patient who presented with a neck mass associated with shortness of breath and hemoptysis. Read More

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January 2022

Total neoadjuvant therapy for pancreatic adenocarcinoma increases probability for a complete pathologic response.

Eur J Surg Oncol 2022 Jan 5. Epub 2022 Jan 5.

Departments of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA. Electronic address:

Background: Multiple neoadjuvant therapy protocols have been proposed in the treatment of pancreatic adenocarcinoma, including chemotherapy (CT), chemoradiation (CRT), and total neoadjuvant therapy (TNT), defined as a CT plus CRT. A pathologic complete response (pCR) can be achieved in a minority of cases. We hypothesize that TNT is more likely to confer pCR than other neoadjuvant therapies, which may improve overall survival (OS). Read More

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January 2022

The aborted Whipple: Why, and what happens next?

J Surg Oncol 2022 Mar 11;125(4):642-645. Epub 2022 Jan 11.

Department of Surgery, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, USA.

Background: For patients with periampullary adenocarcinoma (PAC), pancreatoduodenectomy (PD) provides the best survival. Surgery on a subset of patients is aborted during PD. We analyzed these patients. Read More

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Rapidly progressive dementia and intractable diarrhea: a teaching case report and a systematic review of cognitive impairment in Whipple's disease.

Neurol Sci 2022 Feb 3;43(2):907-926. Epub 2022 Jan 3.

Stroke and Dementia Lab, "Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 74, 20157, Milan, Italy.

Objective: Whipple's disease (WD) is a systemic, chronic, relapsing disease caused by Tropheryma whipplei, which can mimic signs and symptoms of various clinical entities. Typical manifestations are represented by gastrointestinal and systemic symptoms, among which neurological ones are frequent. We present the case of a patient with WD and rapidly progressive cognitive impairment and a review of literature aimed to report epidemiological, clinical, neuroimaging, and laboratory findings of cognitive impairment associated with WD. Read More

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February 2022

Role of enteroscopy in the diagnosis of whipple's disease.

Acta Gastroenterol Belg 2021 Oct-Dec;84(4):669-671

Department of Gastroenterology, Centro Hospitalar Universitário de São João, Porto, Portugal.

Whipple's disease is a rare chronic systemic infection caused by Tropheryma whipplei. The widespread infection by this rod is responsible for the protean clinical manifestations of the disease, although its classical form is notable for the prevalence of abdominal symptoms such as chronic diarrhea and abdominal pain. Whitish-yellow patches, suggestive of lymphangiectasia, are typically observed in the duodenum during upper endoscopy. Read More

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December 2021

Robotic versus Open Pancreatoduodenectomy for Pancreatic and Periampullary Tumors (PORTAL): a study protocol for a multicenter phase III non-inferiority randomized controlled trial.

Trials 2021 Dec 27;22(1):954. Epub 2021 Dec 27.

Department of Pancreatic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: Pancreatoduodenectomy is a complex and challenging procedure that requires meticulous tissue dissection and proficient suturing skills. Minimally invasive surgery with the utilization of robotic platforms has demonstrated advantages in perioperative patient outcomes in retrospective studies. The development of robotic pancreatoduodenectomy (RPD) in specific has progressed significantly, since first reported in 2003, and high-volume centers in pancreatic surgery are reporting large patient series with improved pain management and reduced length of stay. Read More

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December 2021

[Clinical effect of minimally invasive duodenum preserving pancreatic head resection for benign and pre-malignant lesions of pancreatic head].

Zhonghua Wai Ke Za Zhi 2022 Jan;60(1):39-45

Bengbu Medical College,Bengbu 233030,China.

To examine the clinical effect of minimally invasive duodenum preserving pancreatic head resection(DPPHR) for benign and pre-malignant lesions of pancreatic head. The clinical data of patients with diagnosis of benign or pre-malignant pancreatic head tumor were retrospectively collected and analyzed,all of them underwent laparoscopic or robotic DPPHR between October 2015 and September 2021 at Division of Gastrointestinal and Pancreatic surgery,Zhejiang Provincial People's Hospital. Thirty-three patients were enrolled with 10 males and 23 females. Read More

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January 2022