Perforated duodenal diverticulum: A Case Report

Gülmez, Mehmet; Yıldız, Mehmet Kamil; Odabaşı, Hacı Mehmet; Abuoğlu, Hacı Hasan; İlhan, Onur Alp; Kaytaz, Kübra

doi:10.14744/nci.2016.50469

Cited by 4 publications

(2 citation statements)

References 10 publications

(12 reference statements)

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“…Perforation is the rarest complication, with only about 200 cases reported in the literature [ 11 ], with potentially dramatic sequelae and high mortality (8%–34%) [ 12 ]. Diverticulitis is the most common cause of perforation, followed by enterolithiasis, iatrogenic perforation due to ERCP, ulceration and trauma [ 4 , 5 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence rate at autopsy is 22% and an increase in prevalence is seen with age [ 1 , 2 ]. The most part (60%) of duodenal diverticula are located in the second portion of the duodenum, followed by third portion (30%) and few (8%) are present in the fourth segment of duodenum [ [3] , [4] , [5] , [6] ]. Patients with duodenal diverticula are usually asymptomatic, and the diagnosis is frequently made during endoscopic retrograde cholangiopancreatography (ERCP) [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Traumatic perforated diverticulum of the fourth duodenal portion: First case report and literature review

Palumbo

Miceli

Mattone

et al. 2020

Annals of Medicine and Surgery

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Introduction Duodenal rupture following blunt abdominal trauma is rare, and traumatic rupture of duodenal diverticula is exceptional. However, duodenum is the second most frequent location of intestinal diverticula following colon. Duodenal diverticula are common but only in few cases they are symptomatic due to the onset of complications such as inflammation, hemorrhage, or perforation. Perforation, although rare, especially post-trauma, is the most serious life threatening complication. Case presentation We report the case of a patient who, 24 hours after a blunt trauma secondary to a car accident, complained symptoms related to the perforation of a diverticulum of the fourth portion of the duodenum. A computed tomography was performed and extraluminal fluid-air collection was identified. During emergent laparotomy, a fourth portion perforated duodenal diverticulum was diagnosed, and resected. The recovery was uneventful. Discussion Diagnosis of perforated duodenal diverticulum represents a challenge in diagnosis and few guidelines exist about the management of this rare occurrence, especially in a traumatic setting. The present case is the first report of traumatic perforated diverticulum of the fourth duodenal portion. Conclusion Surgery still remain the most common approach in the treatment of this pathology, including diverticulectomy and primary repair.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Traumatic perforated diverticulum of the fourth duodenal portion: First case report and literature review

Palumbo

Miceli

Mattone

et al. 2020

Annals of Medicine and Surgery

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A systematic review of the perforated duodenal diverticula: lessons learned from the last decade

Kapp

Müller

Gertsch

et al. 2021

Langenbecks Arch Surg

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Background The perforated duodenal diverticulum remains a rare clinical entity, the optimal management of which has not been well established. Historically, primary surgery has been the preferred treatment modality. This was called into question during the last decade, with the successful application of non-operative therapy in selected patients. The aim of this systematic review is to identify cases of perforated duodenal diverticula published over the past decade and to assess any subsequent evolution in treatment. Methods A systematic review of English and non-English articles reporting on perforated duodenal diverticula using MEDLINE (2008–2020) was performed. Only cases of perforated duodenal diverticula in adults (> 18 years) that reported on diagnosis and treatment were included. Results Some 328 studies were identified, of which 31 articles met the inclusion criteria. These studies included a total of 47 patients with perforated duodenal diverticula. This series suggests a trend towards conservative management with 34% (16/47) of patients managed non-operatively. In 31% (5/16) patients initially managed conservatively, a step-up approach to surgical intervention was required. Conclusion Conservative treatment of perforated duodenal diverticula appears to be an acceptable and safe treatment strategy in stable patients without signs of peritonitis under careful observation. For patients who fail to respond to conservative treatment, a step-up approach to percutaneous drainage or surgery can be applied. If surgery is required, competence in techniques ranging from simple diverticulectomy to Roux-en-Y gastric diversion or even Whipple’s procedure may be required depending on tissue friability and diverticular collar size.

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Rare Types of Perforation of the Gastrointestinal Tract — Diagnosis, Tactics, Treatment

Blagovestnov

Kopaliani²,

Yartsev

et al. 2022

Neotložnaâ med. pomoŝʹ

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RATIONALE Hollow organ perforation is an urgent problem in abdominal surgery. According to the literature, the incidence of perforation is from 0.37% to 2.3% of cases among various acute surgical pathologies of the abdominal organs. The greatest attention in the literature is paid to the problem of perforated gastroduodenal ulcers. At the same time, a much smaller number of publications, both Russia and foreign, are devoted to other, more rare types of perforations. This situation is most likely explained by the low prevalence of other types of perforations, which, in turn, does not make them a less urgent problem in emergency surgery, which requires a modern approach to the treatment of this group of patients.PURPOSE OF THE STUDY Analysis of domestic and foreign literature on the diagnosis and treatment of rare types of benign intestinal perforations.MATERIAL AND METHODS A literature review was performed for the period from 1994 to 2020 in Russian and in English, available on Pubmed, Medline, Springer, Scopus, E-library, on topics such as perforated diverticula of the small intestine, perforation of Meckel’s diverticulum, perforated ulcers of the small intestine, perforation of the intestine by a foreign body. RESUltS With all the variety of surgical techniques for various types of perforation of the gastrointestinal tract, currently in the literature there are no specific criteria for choosing a particular method of intervention with regard to the cause, level, and duration of perforation.CONCLUSION The lack of unified approaches in the diagnosis and treatment of patients with rare GIT perforations dictates the need for a more in-depth study of this issue in order to apply and optimize the technique of videolaparoscopic approach, develop a treatment and diagnostic algorithm for patients with suspected perforations of the gastrointestinal tract using the video laparoscopic method.

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Perforated duodenal diverticulum: A Case Report

Cited by 4 publications

References 10 publications

Traumatic perforated diverticulum of the fourth duodenal portion: First case report and literature review

Traumatic perforated diverticulum of the fourth duodenal portion: First case report and literature review

A systematic review of the perforated duodenal diverticula: lessons learned from the last decade

Rare Types of Perforation of the Gastrointestinal Tract — Diagnosis, Tactics, Treatment

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