腸石嵌頓性十二指腸憩室炎に対し内視鏡的腸石除去術にて治療し得た1例

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  • A case of Acute Duodenal Diverticulitis with an Enterolith treated with endoscopic therapy

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A 67-year old man was admitted for evaluation of two days of epigastric pain. Abdominal CT scan showed fluid collection around the horizontal duodenum and a diverticulum with focal calcification, which suggested duodenal diverticulitis with a presence of Enterolith. Initial treatment consisted of fluid resuscitation, broad-spectrum antibiotics began. Initial endoscopy on hospital day three revealed a large diverticulum with an impacted enterolith in the diverticular cavity. After removal of the enterolith using gripping forceps, a significant amount of pus was expressed, revealing a deep ulcer at the base of the diverticulum. Follow-up endoscopy on hospital day eight revealed normal-appearing diverticulum and a reduction of the ulcer. This case demonstrates that in the absence of perforation, endoscopic therapies are effective for Duodenal Diverticulitis. However, early diagnosis and attentive technique is needed.

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