Endoskopische Spaltung eines intraluminalen Duodenaldivertikels beim Erwachsenen wegen Oberbauchbeschwerden

Abstract

We report here on a 44-year-old previously healthy patient with a two-year history of intermittent upper abdominal pain. In the outpatient gastroduodenoscopy and X- ray examinations of the small intestine an intraluminal duodenal diverticulum was suspected. Clinical examination and laboratory tests did not show any abnormal findings. In order to exclude other causes for the patient's complaints coloscopy, ERP and MRCP were performed. The latter was done because the bile duct could not be intubated in the ERCP due to the altered anatomy. By use of endoscopic ultrasound a mucosal duplication was demonstrated and thus the diagnosis confirmed. Subsequently, the diverticulum sac was sliced by argon plasma coagulation. The postinterventional course was without complications and the patient was without symptoms afterwards. The intraluminal duodenal diverticulum is a rare differential diagnosis of pain in the upper abdomen. The diverticulum should be endoscopically removed if other causes for abdominal pain have been ruled out and possibly associated malformations have been excluded.

Management of a windsock diverticulum by the use of novel submucosal dissection scissors

“…After identification, endoscopic diverticulectomy or diverticulotomy can be performed, and many techniques have been described. A variety of devices have been reported, including standard polypectomy snares, needle-knife papillotomes, standard sphincterotomes, and endoscopic submucosal dissection knives 6, 7, 8. After resection or incision, the endoscopist should be aware that these lesions are known to be very vascular and are prone to both immediate and delayed bleeding.…”