Duodenal diverticulum treated by excision of mucosal pouch only

Abstract

active ulcers. No active ulcers were recorded in any of our patients. The pseudodiverticula were not ulcer craters because of the absence of rigidity and tenderness and the contractility of the pouches. Moreover, there was no history suggestive of recurrence of the ulcer. I n the absence of cine-radiographic studies the transit time for the barium suspension to traverse the distance between the cardio-oesophageal junction and the duodenojejunal flexure can be a useful guide as to the patency of the gastroduodenal channel, mindful of the fact that it can be modified by the shape and size of the stomach and peristaltic activity. However, the transit time from the cardiooesophageal junction to the duodenojejunal flexure in post-pyloroplasty patients was shorter than in normal subjects (Bohrer, 1969). The configuration of the gastroduodenal channel in group 2 patients is considered to represent an unsuccessful pyloroplasty (Bloch and Wolf, 1965) although a majority of these patients are asymptomatic (Wilkins, 1953).T h e results of vagotomy and pyloroplasty in the treatment of duodenal ulceration in Nigerians have been satisfactory and compare favourably with the findings of other workers (Ellis and others, 1966).T h e incidence of diarrhoea in this series is over 35 per cent, although less than 5 per cent of the patients required treatment. Our results, although only followed to a maximum of 5 years after operation, were generally satisfactory. This procedure appears to be a reasonable form of treatment to offer our patients provided the necessary precautions are taken.

Retroperitoneal Perforation of a Duodenal Diverticulum with Colonic Necrosis - Report of a Case

“…The operation undertaken in our case, i. e. excision of the diverticulum and two-layer closure of the duodenum is the treatment of choice [5,7,14], but the procedure may be technically difficult posing a risk of damage to the pancreas and biliary and pancreatic ducts, especially in patients with perivaterian diverticula. Excision of the mucosal pouch alone [19] or inversion of the diverticular sac with or without amputation of the sac [26] constitutes an alternative and more simple operative techniques. Duodenostomy is used in cases of extensive inflammation of the preperitoneal area, which has a risk of possible postoperative leakage [7].…”

Clinical analysis and literature review of massive Duodenal diverticular bleeding

“…A survey in t964 revealed 20% postoperative mortality among patients with (1) duodenal diverticulitis; (2) diverticular perforation, fistula, or hemorrhage; or (3) biliary or pancreatic duct obstruction [3]. Excision of the mucosal pouch only [26] or inversion of the diverticular sac with [27] or without [18] amputation of the sac were reported to be safe, simple procedures. We believe that total excision of the diverticulum or partial excision with suture-ligation of the bleeder is an excellent treatment for the bleeding diverticulum; inversion of the diverticulum with sutnre-ligation may be a suitable method for patients with marked edematous changes in the duodenal wall.…”