Duodenal Diverticula

DEFINITION
Pulsion outpouchings.
D E A B M I M


EPIDEMIOLOGY

Incidence

Perhaps 5-10% background incidence
Symptoms uncommon (usually incidental).

Age
Rare before 40 yrs

D E A B M I M
 

AETIOLOGY

Pathogenesis
Divertic.

D E A B M I M
 

BIOLOGICAL BEHAVIOUR

Pathophysiology

Usually on medial aspect of duodenum.
Most solitary, within 2.5cm of AoV.
- not in D1.

Natural history
High incidence of gallstone disease in patients with juxtapapillary diverticula.

Complications
Serious complications are haemorrhage, perforation and biliary obstrction.
Rarely, enteroliths from bile stasis in the divertic.
--> diverticular inflammation.


D E A B M I M
 

MANIFESTATIONS

Presents with complications.

D E A B M I M


INVESTIGATIONS

Imaging
CT

D E A B M I M


MANAGEMENT

Conservative Rx

Operative
Perforation
Resection and closure of the defect is best.
Biliary obstruction in a divertic is complicated, may need choledochoduodenostomy.

D E A B M I M


REFERENCES
Doherty