duodenal diverticulitis

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

Siehe auch:

• Duodenaldivertikel
• Duodenitis
• Perforation eines Duodenaldivertikels

und weiter:

• perforiertes Duodenaldivertikel