A Case of Perforated Duodenal Diverticulum

DOI 1 Citations 17 References
  • Urizono Yasuyuki
    Department of Emergency and Critical Medicine, Nara Medical University
  • Hukushima Hidetada
    Department of Emergency and Critical Medicine, Nara Medical University
  • Hata Tomoaki
    Department of Emergency and Critical Medicine, Nara Medical University
  • Nakamura Tatsuya
    Department of Emergency and Critical Medicine, Nara Medical University
  • Okuchi Kazuo
    Department of Emergency and Critical Medicine, Nara Medical University

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  • 十二指腸憩室穿孔の1手術例

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Abstract

Though the existence of a duodenal diverticulum is often found, spontaneous perforation of a duodenal diverticulum is rare, and we report herein on such a case. A 60-year-old man was admitted with acute onset of abdominal and back pain. Plain radiography of the abdomen showed no free air. Abdominal CT showed a diffuse low density area and abnormal gas in the retroperitoneal cavity near the pancreas head and around the abdominal aorta. We therefore diagnosed perforation of the gastrointestinal tract, and an emergency laparotomy was performed. The duodenum was mobilized with a Kocher maneuver and abscess formation and a perforated diverticulum 2 cm in diameter were found in the lateral side of the 2nd portion of the duodenum. A diverticulectomy and simple closure were performed. Histological examination showed lack of muscle layer with neutrophilic infiltration and fibrinous deposition. The patient's postoperative course was uneventful.

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