J Korean Soc Radiol.  2013 Nov;69(5):373-376. 10.3348/jksr.2013.69.5.373.

Perforated Duodenal Diverticulum Caused by Bezoar: A Case Report

• Lee JE
• Moon SK
• Park SJ
• Lim JW
• Lee DH
• Ko YT

• KMID: 2002858
• DOI: http://doi.org/10.3348/jksr.2013.69.5.373

Abstract

Duodenal diverticulum is common, but its perforation is a rare complication. Duodenal diverticulum perforation requires prompt treatments because of its high mortality rate. However, an accurate diagnosis is difficult to make due to nonspecific symptoms and signs. It can be misdiagnosed as pancreatitis, cholecystitis, or peptic ulcer. Herein, we report a case of perforated duodenal diverticulum caused by bezoar in a 33-year-old woman whom was diagnosed by abdomen computed tomography and ultrasonography.

MeSH Terms

Abdomen
Adult
Bezoars*
Cholecystitis
Diverticulum*
Female
Humans
Pancreatitis
Peptic Ulcer
Ultrasonography

Figure

• 

  Fig. 1 A 33-year-old woman with perforated duodenal diverticulum with epigastric pain. A. On an axial CT image, an irregular fluid collection (asterisk) containing air-bubbles is shown at the posterior aspect of the pancreas uncinate process. It displaces the pancreas head (black arrow) and duodenum (white arrow) anteriorly. B. An abdomen ultrasonography shows a hard material (white arrow) with posterior acoustic shadow in the duodenal diverticulum. The pancreas parenchyma (asterisk) shows normal appearance. C. A coronal CT image shows the discontinuity of the superior wall of duodenal diverticulum (white arrow) and communication (black arrows) with complicated fluid collection (asterisk) around the pancreas head. Note.-D = duodenum

• 

  Fig. 2 The follow-up abdomen CT and endoscopy. A. An axial CT image shows the decrease in size of duodenal diverticulum (white arrow). There is no more fluid collection near the pancreas head and uncinate process (black arrow = duodenum). B. An endoscopy shows the opening of the duodenal diverticulum at the periampullary region.

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