Successful endoscopic treatment of a “windsock” diverticulum: a rare case of duodenal subocclusion

D’Assunção, Marco A.; Costa, Lucas S. Nova da; Mota, Fernando; Igi, Willian Ferreira; Valenciano, Juliana Santos; Ziegler, Amanda Machado Bernardo

doi:10.1055/s-0043-123877

Cited by 4 publications

(6 citation statements)

References 4 publications

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“…Nowadays, with advancements in endoscopy and imaging; endoscopic diverticulotomy or diverticulectomy is the treatment of choice. The endoscopy approach includes using needle-knife papillotomy, sphincterotomy, argon plasma coagulation, yttrium aluminum garnet (YAG) laser, and endostapler have been described [7][8][9][10][11][12][13][14][15][16][17]. In a study by Bhalla et al, the use of a novel technique reported as submucosal dissection scissors (SB knife, (Olympus, Shinjuku City, Tokyo, Japan)) and blended the longitudinal wall by electrocautery showed resolution of symptoms [14].…”

Section: Obstructionmentioning

confidence: 99%

An Uncommon Case of Intraluminal Duodenal Diverticulum Complicated by Recurrent Gastrointestinal Bleeding and Small Bowel Obstruction

Ta¹,

Sandhu²,

Mouchli³

2022

Cureus

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Intraluminal duodenal diverticulum (IDD) is a rare congenital anomaly resulting from the failure of the duodenum to recanalize during embryogenesis leaving a duodenal diaphragm or web within the lumen of the duodenum. In theory, the peristaltic force gradually stretches the tissue over time forming a diverticulum within the duodenal lumen. Identification of IDD by endoscopy or diagnostic imaging can be difficult, these lesions can be mistaken for other lesions or the collapsed diverticulum can be overlooked. The median age of presentation is the fourth decade. Although most cases are asymptomatic, some can present with vague abdominal complaints such as bloating, nausea, abdominal discomfort, or pain. Complications of IDD are intestinal bleeding, biliary pancreatic symptoms, intestinal obstruction, and perforation. Management of IDD complications could be challenging since data are limited. We present an unusual case of a 78-year-old female presenting with acute chest pain, palpitations, and incidental findings of IDD and pancreatic divisum. Her course was complicated by recurrent gastrointestinal bleeding and small bowel obstruction.

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Section: Obstructionmentioning

confidence: 99%

An Uncommon Case of Intraluminal Duodenal Diverticulum Complicated by Recurrent Gastrointestinal Bleeding and Small Bowel Obstruction

Ta¹,

Sandhu²,

Mouchli³

2022

Cureus

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“…An intraluminal duodenal diverticulum is a rare congenital anomaly stemming from incomplete duodenal lumen formation during embryogenesis 1 2 3 4 5 . Over time, the remnant duodenal diaphragm resembles a windsock by elongation secondary to intestinal peristaltic movements 1 2 3 . In most patients, the condition is detected incidentally 1 2 .…”

Section: Figmentioning

confidence: 99%

“…Over time, the remnant duodenal diaphragm resembles a windsock by elongation secondary to intestinal peristaltic movements 1 2 3 . In most patients, the condition is detected incidentally 1 2 . However, a few patients may present in adulthood with symptoms of partial duodenal obstruction, such as early satiety, vomiting, and abdominal pain 1 2 .…”

Section: Figmentioning

confidence: 99%

“…In most patients, the condition is detected incidentally 1 2 . However, a few patients may present in adulthood with symptoms of partial duodenal obstruction, such as early satiety, vomiting, and abdominal pain 1 2 . Rare bleeding and pancreatitis may complicate the scenario 1 2 .…”

Section: Figmentioning

confidence: 99%

“…However, a few patients may present in adulthood with symptoms of partial duodenal obstruction, such as early satiety, vomiting, and abdominal pain 1 2 . Rare bleeding and pancreatitis may complicate the scenario 1 2 . Herein we present a case treated with endoscopic intraluminal diverticulectomy ( Fig.…”

Section: Figmentioning

confidence: 99%

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A rare case of a windsock-shaped intraluminal duodenal diverticulum treated successfully with endoscopic diverticulectomy

et al. 2022

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Endoscopic Balloon Dilatation-Based Membrane Resection for Membranous Duodenal Stenosis: A Feasibility and Safety Study (With Video)

Wang

Lin

Liu

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Surgery is generally considered as the first-line therapy for membranous duodenal stenosis (MDS) in children. However, abdominal surgery leaves permanent scars and may even cause intestinal adhesion. Therefore, an effective, safe, and minimally invasive method is urgently needed. This study aimed to evaluate the safety, efficacy, and feasibility of endoscopic balloon dilatation-based membrane resection (EBD-MR) to treat MDS in children. Methods: We retrospectively reviewed patients with MDS treated with EBD-MR in Shanghai Children’s Hospital from May 2016 to August 2021. Primary study outcome was clinical success, defined as weight gain and complete remission of vomiting, without the need for repeat endoscopic or surgical intervention during follow-up. Secondary outcomes included technical success, diameter changes of the membrane opening, and adverse events. Results: Nineteen children (9 females, mean age 14.5 ± 11.2 months) received endoscopic treatment for MDS, and clinical success was achieved in 18 of 19 patients (94.7%). No bleeding, perforation, and jaundice occurred. Diameters of the membrane opening increased from 2.97 ± 2.87 mm to 9.78 ± 1.27 mm after the treatment, symptoms of vomiting did not reappear during 10–73 months of follow-up, and body mass index of the children increased from 14.9 ± 2.2 kg/m2 (pre-operation) to 16.2 ± 3.7 kg/m2 (6 months after operation). One patient required surgical revision because of existence of a second web; three patients received 2–3 sessions of endoscopic treatment to obtain the final remission. Conclusions: The EBD-MR technique is safe, effective, and feasible for MDS, which provided an excellent alternative to surgical management for the disease in pediatric patients.

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Successful endoscopic treatment of a “windsock” diverticulum: a rare case of duodenal subocclusion

Abstract: E-Videos ▶ Fig. 1 Barium contrast study of the small bowel suggesting a "windsock sign" (arrow). E65This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Cited by 4 publications

References 4 publications

An Uncommon Case of Intraluminal Duodenal Diverticulum Complicated by Recurrent Gastrointestinal Bleeding and Small Bowel Obstruction

An Uncommon Case of Intraluminal Duodenal Diverticulum Complicated by Recurrent Gastrointestinal Bleeding and Small Bowel Obstruction

A rare case of a windsock-shaped intraluminal duodenal diverticulum treated successfully with endoscopic diverticulectomy

Endoscopic Balloon Dilatation-Based Membrane Resection for Membranous Duodenal Stenosis: A Feasibility and Safety Study (With Video)

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