Complications of Duodenal Diverticula

Munnell, Edward R.

doi:10.1001/archsurg.1966.01320190154034

Cited by 50 publications

(10 citation statements)

References 10 publications

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“…Duodenal diverticula are frequent incidental findings in radiographic and endoscopic examinations [21]or during operations on the biliopancreatic system, mainly in elderly patients [12, 22, 23]. The mean age of 63 years in our patients is not different from previous reports [1, 24, 25, 26].…”

Section: Discussionmentioning

confidence: 53%

Ampullary but Not Periampullary Duodenal Diverticula Are an Etiologic Factor for Chronic Pancreatitis

Naranjo-Chavez¹,

Schwarz²,

Leder³

et al. 2000

Dig Surg

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Background: Duodenal diverticula are common incidental findings. Although a definite treatment is rarely required, an association with biliary and pancreatic diseases is often suggested. Our aim was to determine the frequency of complications in relation to the location of the diverticulum. Methods: We reviewed 64 patients with extraluminal duodenal diverticula. In 24 of these patients the diverticulum was treated surgically. The incidence of symptoms and complications is analyzed and follow-up in 88% of operated patients is presented. Results: Thirty-one patients presented with ampullary, 36 patients with periampullary diverticula. Three patients had both types of diverticula. The indication for surgery in 24 patients was chronic pancreatitis (n = 12), chronic pain (n = 6), diverticular perforation (n = 3), bleeding (n = 2), or jaundice (n = 1). In 7 out of 31 patients with ampullary and none out of 36 patients with periampullary diverticula, chronic pancreatitis was considered to be induced by the diverticulum. Morbidity in 24 operated patients was 17%, no patient died. At follow-up all patients were free of symptoms. Conclusion: Extraluminal duodenal diverticula are frequently found. They rarely cause symptoms and need no surgical treatment. While ampullary duodenal diverticula can cause chronic pancreatitis, periampullary duodenal diverticula are no etiologic factor.

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Section: Discussionmentioning

confidence: 53%

Ampullary but Not Periampullary Duodenal Diverticula Are an Etiologic Factor for Chronic Pancreatitis

Naranjo-Chavez¹,

Schwarz²,

Leder³

et al. 2000

Dig Surg

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“…Rarer complications are biliary obstruction and pancreatitis from inadvertent suturing of the ampulla of Vater. This can occur when the diverticulum is in close proximity to the papilla [17]. In this location, attempted repair could result in injury to the ampulla, pancreatic or biliary ducts and can cause bleeding from the pancreatico-duodenal vascular arcade.…”

Section: Discussionmentioning

confidence: 99%

Perforated Duodenal Diverticulitis: A Report of Three Cases

Miller¹,

Mueller²,

Yim³

et al. 2005

Dig Surg

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Background: Duodenal diverticuli are present in up to 22% of the population. However, perforation of a duodenal diverticulum with spillage of enteric contents into the retroperitoneum is rare. Methods: We report three cases of perforated duodenal diverticulitis. Results: Clinical presentations varied widely from patients with acute abdominal findings and generalized sepsis to a patient with mild symptoms of abdominal discomfort. CT scanning was the imaging modality used to make an accurate diagnosis. Treatment approaches for the most stable patient included nonoperative management with antibiotics, bowel rest and parenteral alimentation, while the less stable patients underwent definitive surgery with complete diversion of gastric contents and biliary flow from the affected area of duodenum. Conclusions: This report highlights the salient issues in the presentation, diagnosis and modern management of patients with this potentially catastrophic disease.

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“…Use of this simple technique prevents gastric juice flows into the duodenum. As a result, a patient may be able to start eating meals sooner postoperatively, regardless of whether the resected site is recovered [14].…”

Section: Discussionmentioning

confidence: 99%

Naujas perforavusio dvylikapirštės žarnos divertikulo gydymas atliekant Roux-en-Y duodenojejunostomiją

Šileikis¹,

Šileikytė²

2017

LietChirur

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Duodenum diverticulum is the most common site for diverticular disease of small intestine. Symptomatic duodenal diverticulum are 1% to 5%, which present with pain, bleeding, inflammation, cholestasis, cholangitis, obstruction, perforation, pancreatitis, or malignant transformation. The most difficult complication is perforation -0.03%. Once duodenal diverticulitis perforation has been diagnosed, traditional management has been simple diverticulectomy and two layer closure of the duodenum with drainage of the retroperitoneum. However, nowadays there is increase in case reports of successful conservative and different surgical treatment. We present our experience by treating duodenal diverticulitis with simple diversion by Roux-en-Y duodenojejunostomy according to Shigeru Fujisaki after unsuccessful conservative treatment. Key words: duodenum diverticulitis, perforation, treatment Dvylikapirštės žarnos divertikulai yra dažniausia divertikuliozės vieta plonojoje žarnoje. Nuo 1 % iki 5 % tokių divertikulų yra simptominiai ir pasireiškia skausmu, kraujavimu, uždegimu, cholestaze, cholangitu, obstrukcija, perforacija, pankreatitu ar piktybine transformacija. Pati sudėtingiausia komplikacija yra perforacija, kuri sudaro 0,03 %. Diagnozavus dvylikapirštės žarnos divertikulo perforaciją, tradicinis gydymas buvo paprasta divertikulektomija ir dvylikapirštės žarnos užsiuvimas dviem sluoksniais su retroperitoninio tarpo drenavimu. Pastaruoju metu aprašoma vis daugiau sėkmingų konservatyvaus ir kitokio chirurginio gydymo atvejų. Mes aprašome savo patirtį, susijusią su dvylikapirštės žarnos divertikulito gydymu atliekant Roux-en-Y duodenojejunostomiją Shigeru Fujisaki metodu po nesėkmingo konservatyvaus gydymo. Reikšminiai žodžiai: dvylikapirštės žarnos divertikultas, perforacija, gydymas 194

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Complications of Duodenal Diverticula

Cited by 50 publications

References 10 publications

Ampullary but Not Periampullary Duodenal Diverticula Are an Etiologic Factor for Chronic Pancreatitis

Ampullary but Not Periampullary Duodenal Diverticula Are an Etiologic Factor for Chronic Pancreatitis

Perforated Duodenal Diverticulitis: A Report of Three Cases

Naujas perforavusio dvylikapirštės žarnos divertikulo gydymas atliekant Roux-en-Y duodenojejunostomiją

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