A duodenal web, diaphragm or intraluminal diverticulum refers to a complete or incomplete obstruction at the duodenum due to a membranous web or intraluminal diverticulum. There is usually a small aperture at the center differentiating this from duodenal atresia.
Although they are frequently congenital and occur in the pediatric population, some can present in adults and may also be acquired . The presentation can be variable depending on the size of the aperture.
They have a tendency to occur at the 2 part of the duodenum .
If severely obstructive may show a double bubble sign.
Can typically give a "windsock sign" (gradual ballooning of the duodenal diaphragm) or "halo sign" due to the web projecting caudally into the duodenal lumen.
Duodenal dimple sign; when pressure is exerted by NG tube on the obstructive web can cause dimpling of duodenal wall nearby.
- may show a dilated stomach and proximal duodenum
- may how a hypoechoic intraluminal diverticulum
Imaging differential considerations include: