A Case of Congenital Duodenal Diaphragm in an Adult.

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  • 先天性十二指腸膜様狭窄の１成人例

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Abstract

Duodenal diaphragm is a congenital disease and is usually diagnosed in infancy. A rare case of adult duodenal obstruction caused by a web is reported. A 23-year-old man complaining of vomiting was referred to the hospital with a suspicion of duodenal stenosis. With examinations including an upper gastrointestinal series and endoscopy, duodenal diaphragm was diagnosed. Thorough examinations such as cholangiography were performed in order to identify the opening of the bile duct. At the time of operation, although string surrounding duodenum was found and excised, the duodenal web was not apparent. Eventually, perioperative endoscopy revealed the menbranous stenosis at the entirely same location as the string. Since the membrane was pretty thick and bile run out of it, we performed a duodenoduodenostomy instead of excising the diaphragm to avoid injuring the papilla of Vater. The postoperative course was uneventful.<br>It is not always easy to identify the exact position of the membrane. Intraoperative endoscopy are helpful to make the definite diagnosis for the disease.

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