Korean J Helicobacter Up Gastrointest Res.  2015 Jun;15(2):132-135. 10.7704/kjhugr.2015.15.2.132.

A Rare Cause of Acute Upper Abdominal Pain: Diverticulitis of the 3rd Portion of the Duodenum

• Ahn YW
• Lee KN
• Doo EY
• Yoo KD
• Kim YT
• Lee KW
• Lee OY
• Yoon BC

• KMID: 2249863
• DOI: http://doi.org/10.7704/kjhugr.2015.15.2.132

Abstract

Duodenal diverticulitis is a rare cause of upper abdominal pain and is usually not considered when evaluating patients with acute upper abdominal pain. Furthermore, the duodenum is located near the pancreas and bile duct, and duodenal diverticulitis can be misdiagnosed as acute pancreatitis, cholangitis, cholecystitis, or other pancreatobiliary disorders such as pancreatic cystic neoplasms. Recently, we experienced a rare case of duodenal diverticulitis in the 3rd portion of the duodenum. The patient presented with deep seated upper abdominal pain aggravated by supine posture and relieved by sitting up. The patient was initially diagnosed with acute pancreatitis. However, serum levels of pancreatic enzymes were normal and abdominal CT scan revealed diverticulitis in the 3rd portion of the duodenum. The patient was successfully managed conservatively. Delayed diagnosis of duodenal diverticulitis can result in substantial morbidity and mortality if duodenal perforation occurs and should be considered as a possible cause of upper abdominal pain.

Keyword

Abdominal pain; Duodenal diverticulum; Diverticulitis; Pancreatitis

MeSH Terms

Abdominal Pain*
Bile Ducts
Cholangitis
Cholecystitis
Delayed Diagnosis
Diverticulitis*
Duodenum*
Humans
Mortality
Pancreas
Pancreatic Cyst
Pancreatitis
Posture
Tomography, X-Ray Computed