Perforation of Duodenal Diverticulum: A Case Report of Duodenal Diverticularization Surgery

Abstract

The patient, an 83-year-old woman, visited another hospital with the complaint of hematemesis, and was diagnosed as having duodenal diverticular bleeding. She was transported to our hospital for further management, as the diverticulum perforated while she was undergoing endoscopic treatment.Abdominal computed tomography showed a hematoma and free gas around the perforation, which were thought to be caused by the perforated duodenal diverticulum, and emergency laparotomy was performed. Intraoperatively, hematoma, emphysema and inflammation were pronounced at the affected site. A perforated diverticulum was noted on the outside of the descending peduncle of the duodenum, which was resected at the site of the healthy intestinal wall using an automatic suture device.At the same operation, the gallbladder was removed and a drainage tube was placed in the cystic duct. After distal gastrectomy and postcolonic Roux-Y reconstruction (duodenal diverticulum), a drainage tube was placed retrogradely in the duodenal stump. The operation time was 3 hours 11 minutes.The postoperative course of the patient was satisfactory and she was discharged 16 days after the surgery.