十二指腸憩室穿孔４例の検討

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  • Four Cases of Perforated Duodenal Diverticulum

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We experienced four cases of perforated duodenal diverticulum between January 1999 and December 2005. We reviewed 38 cases of perforated duodenal diverticulum reported in Japanese medical literature, including our own cases reported here, and then assessed the pathophysiology and treatment policies for perforation, which is a rare complication of duodenal diverticulum. The mean age of the patients with perforated duodenal diverticulum was 68.6 years, and the patients comprised 9 men and 29 women. Most of the chief complaints were abdominal pain, but the location was variable. Many cases were not associated with leukocytosis or muscular defense. The preoperative established diagnosis was low, 26.3%, and this condition was often difficult to diagnose. CT findings were the most useful results, enabling a definite diagnosis in 96.6% of the cases; retroperitoneal emphysema was also a characteristic feature. Surgery was the most common treatment. Most of the patients successfully underwent appropriate decompression and drainage in addition to a diverticulectomy. Nevertheless, the variable findings often make a definite diagnosis difficult, possibly leading to a deterioration in the patient. s condition.

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