Simple Diversion by Duodenojejunostomy for a Retroperitoneal Perforation of the Second Portion of the Duodenal Diverticulum

Abstract

We herein describe that a Roux-en-Y duodenojejunostomy is a simple and secure procedure for perforated diverticulum in the second portion of the duodenum. The surgical technique for perforated duodenal diverticulum can be adaptable when it is difficult to achieve closure of the perforated site easily. Patients who undergo the operation may be able to eat meals, even if duodenal fistula occurs in the postoperative course.

Naujas perforavusio dvylikapirštės žarnos divertikulo gydymas atliekant Roux-en-Y duodenojejunostomiją

“…We prefer simple Roux-en-Y diversion by duodenojejunostomy for the treatment of duodenal diverticulum retroperitoneal perforation described by Shigeru Fujisaki in 2014 [11]. Use of this simple technique prevents gastric juice flows into the duodenum.…”

“…At this case conservative treatment was not effective and the patient was successful treated with simple diversion by Roux-en-Y duodenojejunostomy according to Shigeru Fujisaki [11] (Figure 1). …”

Foregut Diverticula

“…In cases of perforated duodenal diverticulum with minimal-to-mild inflammation, diverticulectomy is performed via the single-or doublelayer closure of the duodenum followed by drainage of any residual fluid collection. 23) Other approaches for patients with mild symptoms who are poor surgical candidates include nonoperative management with intravenous antibiotics, bowel rest, nasogastric tube decompression, and percutaneous drainage of fluid collections. 21) If extensive inflammatory changes occur, primary closure of the duodenum may not be possible, and a Whipple procedure may be indicated.…”

“…21) Owing to www.kjfm.or.kr 5 the rarity of this condition, no standardized treatment protocol has been established. 21,23) JEJUNUM AND ILEUM…”

Perforation of Duodenal Diverticula Treated with Endoscopic Stenting: A Case Report

“…Bizim olgumuzda da ameliyat sonrası çekilen kontrastlı karın BT'de retroperitoneal alanda perforasyona bağlı gaz görünümü vardı. Bu nedenle, BT'nin özgüllüğü %100'ün altında olsa bile genellikle yapılması gereken ilk tanı yöntemidir (7) . Doğru tanı hem antibiyotikler hem de yoğun bakımdaki gelişmelerle birlikte normalde %13'e kadar yüksek olan mortalite son zamanlarda azalmıştır.…”