Divertikulitis Duodenum
Duodenal diverticulitis (plural diverticulitides) is a rare, inflammatory complication of duodenal diverticula.
Clinical presentation
While the vast majority of patients are asymptomatic, patients with diverticulitis usually present with epigastric pain, nausea and vomiting.
Radiographic features
CT
- duodenal diverticulum wall thickening (possible)
- adjacent mesenteric or retroperitoneal fat stranding
- thickening of 2 and 3 parts of the duodenum
- rare findings: pneumoperitoneum and pneumoretroperitoneum
Treatment and prognosis
Conservative treatment is applied to patients who are clinically stable with no secondary peritonitis. Surgery is warranted only in complicated cases, with a high rate of complications as duodenal leak, fistula, and sepsis .
Complications
- perforation of duodenal diverticulitis: rare and hard to diagnose by imaging in the setting of diverticulitis preoperatively
Differential diagnosis
- contained perforation of duodenal ulcer
- acute pancreatitis: show elevated pancreatic enzymes
- paraduodenal pancreatitis: involving the pancreaticoduodenal groove with no duodenal diverticulum
- cystic pancreatic head neoplasms
- peripancreatic abscess/pseudocyst
- peripancreatic lymphadenopathy
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Assoziationen und Differentialdiagnosen zu Divertikulitis Duodenum:
