Korean J Gastroenterol.  2015 Sep;66(3):159-163. 10.4166/kjg.2015.66.3.159.

Management of Perforated Duodenal Diverticulum: Report of Two Cases

• Song S

• KMID: 2373332
• DOI: http://doi.org/10.4166/kjg.2015.66.3.159

Abstract

Duodenal diverticula are common, but perforated duodenal diverticulum is rare. Because of the disease rarity, there is no standard management protocol for perforated duodenal diverticulum. To properly manage this rare complication, a clear preoperative diagnosis and clinical disease severity assessment are important. An abdomino-pelvic CT is an unquestionably crucial diagnostic tool. Perforation is considered a surgical emergency, although conservative treatment based on fasting and broad-spectrum antibiotics may be offered in some selected cases. Herein, we report two cases of perforated duodenal diverticulum, one case managed with surgical treatment and one with conservative treatment.

Keyword

Duodenum; Diverticulum; Intestinal perforation

MeSH Terms

Aged
Diverticulum/complications/*diagnosis/surgery
Duodenal Diseases/complications/*diagnosis/surgery
Endoscopy, Digestive System
Humans
Intestinal Perforation/*diagnosis/etiology/surgery
Male
Middle Aged
Tomography, X-Ray Computed

Figure

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  Fig. 1. Abdomino-pelvic CT image in a 53-year-old male in the present case. Axial CT image of perforated duodenal diverticulum with a foreign material demonstrated by a complex collection with fluid and gas surrounding the second portion of the duodenum (arrowheads).

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  Fig. 2. An isolated perforated duodenal diverticulum on an antero-medial side of duodenal 2nd portion. Black arrowheads show the perforation site, and white arrowheads show the stalk of diverticulum.

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  Fig. 3. Abdomino-pelvic CT image in a 73-year-old male in the present case. Suspected duodenal perforation denoted by retroperitoneal air (arrowheads).

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  Fig. 4. Following CT after 18 days in a 73-year-old male in the present case. The axial image shows a near complete disappearance of fluid collection (arrowheads).

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  Fig. 5. Follow-up esophagogastroduodenoscopy of the present case (arrowheads).

Reference

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