Retroperitoneal perforation arising from duodenal diverticulum treated by endoscopic drainage: a case report

Shirobe, Takashi; Kawakami, Hideyuki; Abe, S.; Yokochi, Tomoki

doi:10.1002/ccr3.921

Cited by 9 publications

(7 citation statements)

References 10 publications

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“…Based on our search on PubMed (2013-present), there have been 29 reports of non-traumatic, noniatrogenic DDP (Table 1) [11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Including our case, the location of DDP was at D2 in 20 cases (67%) and D3 in six cases (20%).…”

Section: Discussionmentioning

confidence: 83%

Perforated Duodenal Diverticulum With Postoperative Diverticulum Bleeding Successfully Treated Using Transcatheter Arterial Embolization

Tomida

Nakagawa

Matsumura

et al. 2021

Cureus

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A diverticulum is a relatively common finding that is generally discovered incidentally; it is most commonly observed in the colon, followed by the duodenum. However, duodenal diverticulum perforation (DDP) is a rare complication. Due to its rarity, its diagnosis is often challenging and the appropriate treatment remains unclear, possibly contributing to its high mortality rate. Traditionally, surgical repair is the primary mode of treatment. However, with the recent advancements in medical technology, conservative management such as bowel rest and endoscopic drainage help successfully manage DDP. Duodenal diverticulum bleeding (DDB) is a rare cause of upper gastrointestinal bleeding. While endoscopic, angiographical, and surgical treatments have been performed to achieve hemostasis, there is no consensus regarding the optimal treatment for DDB. We describe a case of a perforated duodenal diverticulum (DD) with postoperative diverticulum bleeding. Our patient, an elderly female, complained of abdominal pain. Computed tomography images revealed free air in the retroperitoneum, and gastrointestinal perforation was suspected. During the emergency surgery, a perforated DD was detected in the third portion of the duodenum. Due to severe inflammation, diverticulectomy was not performed as it was deemed risky. Instead, we directly sutured the orifice using an omental patch. Duodenal leakage was observed from postoperative day (POD) 3 with bleeding from the remnant DD occurred on PODs 6 and 13. An attempt at endoscopic hemostasis failed, but transcatheter arterial embolization (TAE) was successfully performed. The postoperative course was complicated, and the patient died on POD 54. To the best of our knowledge, this is the first report on DD perforation with postoperative DDB. The remnant DD may be damaged by the digestive juices and result in bleeding. Precautionary measures for duodenal leakage should be undertaken when the DD is unresectable. Additionally, TAE is effective for postoperative DDB.

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Section: Discussionmentioning

confidence: 83%

Perforated Duodenal Diverticulum With Postoperative Diverticulum Bleeding Successfully Treated Using Transcatheter Arterial Embolization

Tomida

Nakagawa

Matsumura

et al. 2021

Cureus

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“…We used the keywords “DDP” and “Endoscopic treatment” to conduct a PubMed search, there were several reports of endoscopic treatment of DDP. The information regarding the reported 7 patients and our case is summarized in Table 1 10,13–17 . Endoscopic treatment of DDP has increased since 2015.…”

Section: Discussionmentioning

confidence: 98%

Duodenal diverticula perforation caused by an impacted bezoar successfully treated by endoscopic drainage and lithotripsy: A case report and literature review

Tadokoro

Oishi

Namba

et al. 2022

Clinical Case Reports

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“…We used the keywords "DDP" and "Endoscopic treatment" to conduct a PubMed search, there were several reports of endoscopic treatment of DDP. The information regarding the reported 7 patients and our case is summarized in Table 1 10,[13][14][15][16][17] . Endoscopic treatment of DDP has increased since 2015.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic treatment of DDP has increased since 2015. An ENBD catheter 17 , stent 15 , and endoscopic negative pressure 16 were used for treatment. In all the cases, antibiotics were administered on admission, and endoscopic treatment was performed concurrently or secondarily.…”

Section: Discussionmentioning

confidence: 99%

Duodenal diverticula perforation caused by an impacted bezoar successfully treated endoscop-ic drainage and lithotripsy: A case report and literature review

Tadokoro

Oishi

Namba

et al. 2022

Preprint

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Retroperitoneal perforation arising from duodenal diverticulum treated by endoscopic drainage: a case report

Cited by 9 publications

References 10 publications

Perforated Duodenal Diverticulum With Postoperative Diverticulum Bleeding Successfully Treated Using Transcatheter Arterial Embolization

Perforated Duodenal Diverticulum With Postoperative Diverticulum Bleeding Successfully Treated Using Transcatheter Arterial Embolization

Duodenal diverticula perforation caused by an impacted bezoar successfully treated by endoscopic drainage and lithotripsy: A case report and literature review

Duodenal diverticula perforation caused by an impacted bezoar successfully treated endoscop-ic drainage and lithotripsy: A case report and literature review

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