PMC3959512_01
Left: Contrast-enhanced computed tomography abdomen: hypodense lesion noted posteromedial to the second part of the duodenum (arrow); Right: Endoscopy showing an extrinsic bulge at the junction of first and second part of the duodenum
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F1
A contrast-enhanced computed tomography (CECT) of the abdomen revealed dilated stomach with a hypodense lesion posteromedial to the second part of the duodenum (Fig. 1; arrow). Careful examination revealed an extrinsic bulge at the area of the narrowing (Fig. 1) and scope was negotiable across this narrowing.
Left: Endoscopic ultrasound (EUS) showing a 1.2 cm cystic lesion in relation to second part of duodenum; Right: Careful EUS examination reveals intact muscularis propria of the duodenal wall around this lesion (arrow), suggesting an intramural location
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F2
Subsequently, endoscopic ultrasound (EUS) was performed with a radial echoendoscope and it revealed a 1.2 cm cystic lesion (Fig. 2) in the second part of the duodenum, at the site of narrowing. Careful examination revealed that muscularis propria of the duodenal wall was seen intact around this lesion (Fig. 2; arrow), suggesting an intramural location.