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Complications of Duodenal Diverticula

Complications of Duodenal Diverticula Abstract A COMMON surgical concept is that a duodenal diverticulum bears no relationship to a patient's symptomatology and is usually found incidentally at the time of gastrointestinal x-ray examination. Moreover, many writers have repeatedly emphasized that its clinical significance is not great because a diverticulum rarely becomes inflamed and does not lead to serious disease. While this thinking is generally true, a striking exception has recently been encountered in a patient who presented with a ruptured duodenal diverticulum, ruptured by an impacted diverticulum stone or enterolith. This prompted an evaluation of the complications of duodenal diverticulitis that are of surgical interest. Report of Case A 69-year-old white, female, retired school-teacher was admitted to the hospital in June of 1964, because of intense, generalized abdominal pain of seven hours' duration. The patient had been ill for five days with nausea, vomiting, and abdominal pain, particularly in the right upper quadrant. From the References 1. Chomel, J.B.L.: Historie de l'Academic Royal , Paris: Institute de France, Academie Des Sciences, 1710, p 37. 2. Morgagni: De sedibus et causis morborum, Par 17, Epist 34, Naple, 1762. 3. Jones, T.W., and Merendino, K.A.: The Perplexing Duodenal Diverticulum , Surgery 48:1068, 1960. 4. Zeifer, H.D., and Goersch, H.: Duodenal Diverticulitis With Perforation , Arch Surg 82:746, 1961.Crossref 5. Maingot, R.: Abdominal Operations (ed 2), New York: Appleton-Century-Crofts, Inc., 1948, pp 101-107. 6. Pappalardo, C., and Sherwin, C.S.: Duodenal Diverticulitis With Perforation , Ann Surg 154:107, 1961.Crossref 7. Castleman, B.: Case Record, Massachusetts General Hospital , New Eng J Med 262:462, 1960.Crossref 8. MacLean, N.J.: Duodenal Diverticulitis , Ann Surg 85:73, 1927.Crossref 9. Shackleton, M.E.: Perforation of a Duodenal Diverticulum With Massive Retroperitoneal Emphysema , New Zeal Med J 62:93, 1963. 10. Rowlands, B.D., and King, P.A.: Duodenal Diverticulum Perforating Into Abdominal Aorta Causing Fatal Hemorrhage , Brit J Surg 41:514, 1954. 11. Sheldon, W.C., et al: Gastrointestinal Hemorrhage From Duodenal Diverticula: Review of Literature and Report of Case , Amer J Dig Dis 4:817, 1959.Crossref 12. Fiddian, R.V.: Duodenal Diverticulum Containing a Stone, Complicated by Perforation , Brit J Surg 48:636, 1960.Crossref 13. Butler, P.F., and Ritvo, M.: Diverticulum of the Duodenum , Boston Med Surg J 192:705, 1925.Crossref 14. Huddy, G.P.B.: Duodenal Diverticula: Report of a Case of Gangrenous Diverticulitis , Lancet 2:327, 1923.Crossref 15. Moore, E.C.: Duodenal Diverticula With Report of a Case , Arch Surg 1:513, 1920.Crossref 16. Hartley, F.H.: Biliary Obstruction: A Case of Common Bile Duct Obstruction as a Complication of Duodenal Diverticulum , J Kansas Med Soc 63:51, 1962. 17. Coors, G.A., and Mitchum, W.R.: Intraluminal Duodenal Diverticulum , Amer J Surg 103:400, 1962.Crossref 18. Kohler, R.: Intraluminal Duodenal Diverticulum , Acta Radiol 54:439, 1960.Crossref 19. Meyer, A.C., and Edgren, D.C.: Duodenal Obstruction by an Intraluminal Diverticulum , Arch Surg 73:1058, 1956.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Complications of Duodenal Diverticula

Archives of Surgery , Volume 92 (1) – Jan 1, 1966

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01320190154034
Publisher site
See Article on Publisher Site

Abstract

Abstract A COMMON surgical concept is that a duodenal diverticulum bears no relationship to a patient's symptomatology and is usually found incidentally at the time of gastrointestinal x-ray examination. Moreover, many writers have repeatedly emphasized that its clinical significance is not great because a diverticulum rarely becomes inflamed and does not lead to serious disease. While this thinking is generally true, a striking exception has recently been encountered in a patient who presented with a ruptured duodenal diverticulum, ruptured by an impacted diverticulum stone or enterolith. This prompted an evaluation of the complications of duodenal diverticulitis that are of surgical interest. Report of Case A 69-year-old white, female, retired school-teacher was admitted to the hospital in June of 1964, because of intense, generalized abdominal pain of seven hours' duration. The patient had been ill for five days with nausea, vomiting, and abdominal pain, particularly in the right upper quadrant. From the References 1. Chomel, J.B.L.: Historie de l'Academic Royal , Paris: Institute de France, Academie Des Sciences, 1710, p 37. 2. Morgagni: De sedibus et causis morborum, Par 17, Epist 34, Naple, 1762. 3. Jones, T.W., and Merendino, K.A.: The Perplexing Duodenal Diverticulum , Surgery 48:1068, 1960. 4. Zeifer, H.D., and Goersch, H.: Duodenal Diverticulitis With Perforation , Arch Surg 82:746, 1961.Crossref 5. Maingot, R.: Abdominal Operations (ed 2), New York: Appleton-Century-Crofts, Inc., 1948, pp 101-107. 6. Pappalardo, C., and Sherwin, C.S.: Duodenal Diverticulitis With Perforation , Ann Surg 154:107, 1961.Crossref 7. Castleman, B.: Case Record, Massachusetts General Hospital , New Eng J Med 262:462, 1960.Crossref 8. MacLean, N.J.: Duodenal Diverticulitis , Ann Surg 85:73, 1927.Crossref 9. Shackleton, M.E.: Perforation of a Duodenal Diverticulum With Massive Retroperitoneal Emphysema , New Zeal Med J 62:93, 1963. 10. Rowlands, B.D., and King, P.A.: Duodenal Diverticulum Perforating Into Abdominal Aorta Causing Fatal Hemorrhage , Brit J Surg 41:514, 1954. 11. Sheldon, W.C., et al: Gastrointestinal Hemorrhage From Duodenal Diverticula: Review of Literature and Report of Case , Amer J Dig Dis 4:817, 1959.Crossref 12. Fiddian, R.V.: Duodenal Diverticulum Containing a Stone, Complicated by Perforation , Brit J Surg 48:636, 1960.Crossref 13. Butler, P.F., and Ritvo, M.: Diverticulum of the Duodenum , Boston Med Surg J 192:705, 1925.Crossref 14. Huddy, G.P.B.: Duodenal Diverticula: Report of a Case of Gangrenous Diverticulitis , Lancet 2:327, 1923.Crossref 15. Moore, E.C.: Duodenal Diverticula With Report of a Case , Arch Surg 1:513, 1920.Crossref 16. Hartley, F.H.: Biliary Obstruction: A Case of Common Bile Duct Obstruction as a Complication of Duodenal Diverticulum , J Kansas Med Soc 63:51, 1962. 17. Coors, G.A., and Mitchum, W.R.: Intraluminal Duodenal Diverticulum , Amer J Surg 103:400, 1962.Crossref 18. Kohler, R.: Intraluminal Duodenal Diverticulum , Acta Radiol 54:439, 1960.Crossref 19. Meyer, A.C., and Edgren, D.C.: Duodenal Obstruction by an Intraluminal Diverticulum , Arch Surg 73:1058, 1956.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1966

References