Abdominal pain in a young woman (2009: 8b)

Zárraga, Fernando López; Ormijana, Julio Saenz de; Orive, M. Diez; Añorbe, Enrique; Aisa, Pilar; Aguirre, Xabier; Arteche, E.; Santarén, Blanca Catón

doi:10.1007/s00330-008-1246-9

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…It is uncommon and fewer cases have been reported in the literature. The prevalence of duodenal diverticula is higher in the people with over than 50-year-old year (1). Diverticulum in duodenum is the second common site to the colon in the alimentary tract (2).…”

Section: Discussionmentioning

confidence: 99%

Clinical challenge: diverticulitis of third and fourth portion of the duodenum with perforation

Ming¹,

Feng

Cherng³

et al. 2012

Rev. esp. enferm. dig.

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Duodenal diverticulum is not rare, and it represents the second most frequent place in the digestive tract. Localization of diverticula in the third or fourth portions of the duodenum is rare and the symptoms are often non-specific. Computed tomography may be helpful to make a diagnosis. We present a rare case of diverticulitis of third and fourth portion of the duodenum with perforation and it was treated successfully by duodenal-jejunostomy and abscess drainage. Case reportA 77-year-old man presented with vomiting and abdominal pain for 1 day prior to the emergency department. On arrival, his vital signs showed temperature of 37.8 ºC, heart rate of 86/min, and blood pressure of 110/68 mmHg. Physical examination revealed tender in the epigastric area with signs of peritoneal irritation. Blood tests were: white blood cells 23,300/mm 3 , hemoglobin, 13.9 g/dL, and platelets, 230,000/mm 3 . The differential count of white blood cell was: neutrophils, 96%; monocytes, 3%; and lymphocytes, 1%. Creactive protein (CRP) was 32.6 ng/dL. The liver and renal function tests and amylase concentrations were normal. Abdominal X-ray showed no intraperitoneal free air. Computed tomography (CT) of abdomen showed extraluminal retroperitoneal air around 3 rd and 4 th portion of the duodenum with fatty stranding. Perforated diverticulitis of the duodenum and a retroperitoneal abscess were considered.The emergency laparotomy was performed. After mobilization (Kocher maneuver), pus was found around retroperitoneal duodenum. Further examination showed a perforated diverticulum in the 3 rd and 4 th portion of the duodenum. We performed the procedure of duodeno-jejunostomy bypass. The abscess cavity was irrigated and multiple drainages were placed. The post-operative course was uneventful. The patient was discharged without complication. DiscussionWe report the patient with perforated diverticulitis in the third and fouth portion of the duodenum. It is uncommon and fewer cases have been reported in the literature. The prevalence of duodenal diverticula is higher in the people with over than 50-year-old year (1). Diverticulum in duodenum is the second common site to the colon in the alimentary tract (2). The typical location is in the second portion of the duodenum (3). Most patients with duodenal diverticula are asymptomatic and they are discovered incidental during upper gastrointestinal image studies. There are only 5% of patients with symptoms resulting from the hemorrhage, inflammation, or perforation (4). Perforation is rare, but the most serious complication. It may be caused by the diverticulitis, enterolithiasis, ulceration, foreign body or trauma (5). Only 1-2% of patients with duodenal diverticula require surgical treatment for complications (4).Abdominal CT is the useful diagnostic tool for duodenal diverticula because it is powerful to demonstrate adjacent anatomy and helpful to find complications such as perforation (3). CT findings may show the mesenteric fat stranding, thickened bowel wall, and an extraluminal, retroperito...

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Section: Discussionmentioning

confidence: 99%

Clinical challenge: diverticulitis of third and fourth portion of the duodenum with perforation

Ming¹,

Feng

Cherng³

et al. 2012

Rev. esp. enferm. dig.

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“…Pulsion diverticula are a result of a combination of increased intraluminal pressure and a defect in the duodenal wall. These diverticula form at sites where the muscularis layer of the duodenal wall is weak, often due to the passage of blood vessels, resulting herniation of the mucosa (38)(39)(40).…”

Section: Case Reportmentioning

confidence: 99%

Duodenal Diverticulum Perforation: A Rare Case Report and Review of the Literature

Yıldız,

İlgun

2024

Batı Karadeniz Tıp Dergisi

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Aim: Duodenal diverticulum is the second most common diverticulum section in the gastrointestinal system, but perforation is rare. It is frequently diagnosed incidentally and has little clinical evidence. There are no certain treatment strategies for duodenal diverticulum perforation. Our aim is to identify perforated duodenal diverticulum cases published in the last 10 years through our case report and to evaluate different approaches to treatment. Case Report: A 58-year-old male was diagnosed central nervous system (CNS) tumor with a perforated duodenal diverticulum. Our case presented with abdominal pain and pneumoperitoneum on imaging. The patient was treated surgically with an omental patch, pyloric exclusion, retrocolic gastrojejunostomy, and tube duodenostomy. The patient died on the 10th postoperative day. Conclusion: Duodenal diverticulum perforation is a rare but fatal condition. CT is useful in diagnosis. If the patient is not in a septic condition, it can be followed conservatively. However, if the patient is in a septic condition, surgery may be required. Surgical options should be determined based on the perforation site and characteristics.

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The Perforated Duodenal Diverticulum

Thorson¹

2012

Arch Surg

185

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Abdominal pain in a young woman (2009: 8b)

Cited by 5 publications

References 14 publications

Clinical challenge: diverticulitis of third and fourth portion of the duodenum with perforation

Clinical challenge: diverticulitis of third and fourth portion of the duodenum with perforation

Duodenal Diverticulum Perforation: A Rare Case Report and Review of the Literature

The Perforated Duodenal Diverticulum

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