Duodenum is the second most common site for diverticula formation. Duodenal diverticula (DD) are asymptomatic incidental findings and their complications are rare. The rarest and most severe complication is DD perforation. Until 2012, only 162 cases of DD perforation were reported in the world literature.
A woman presented with acute abdomen and peritonitis. CT scan revealed hydropneumoretroperitoneum suggestive of duodenal perforation. The patient underwent an exploratory laparotomy and the diagnosis of a DD perforation was made. A diverticulectomy with tube duodenostomy was performed, without complication.
A duodenal diverticulum perforation can be treated either surgically or conventionally. Only selected patients can be treated conventionally. Surgical treatment remains the standard option. Treatment must be individualized.
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