Background: the presence of duodenal diverticula was first described in 1710 by Chromel. Duodenal diverticulum is the second most common site of diverticula in the digestive tract. Anatomically duodenal diverticula are located in 10 to 67% in the second portion of duodenum, and its finding in most cases incidental. About 90% of patients appear asymptomatic, manifesting symptoms mostly once established complications such as: gastrointestinal bleeding and perforation.
Clinical Case: 78-years-old woman who attended our Emergency department with dyspnea, moderate epigastralgia, abdominal bloating, constipation and difficulty to pass gas; Laparotomy was performed to identify duodenal diverticulum in the third portion of the duodenum with a perforation of 5 mm in its cupula. It proceeds with diverticulectomy.
Conclusions: The diagnosis of duodenal diverticulum as a cause of acute abdomen must be considered in our differential diagnosis in acute abdomen supported by imaging and endoscopy. The surgical management of duodenal diverticulum, in particular the resection of the diverticulum, remains as the recommendation for treatment with less morbidity and a good recovery.
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Cureus
December 2024
Gastroenterology, University Hospital Tsaritsa Ioanna, Medical University of Sofia, Sofia, BGR.
Cholecystoenteric fistulas are a rare complication of chronic gallstone disease. If not diagnosed on time, they can cause several complications such as gallstone ileus, gastric outlet obstruction (Bouveret syndrome), cholangitis, or liver abscess. We present a case of a patient with chronic calculous cholecystitis, who was admitted due to unspecific abdominal discomfort and impaired liver function with increased cholestatic liver enzymes.
View Article and Find Full Text PDFCureus
December 2024
Gastroenterology and Hepatology, Monmouth Medical Center, Long Branch, USA.
Lemmel syndrome involves a periampullary duodenal diverticulum (PAD), a pouch-like outpouching near the ampulla of Vater, compressing the common bile duct. We describe a case of severe abdominal pain in a patient who had a large periampullary diverticulum, managed with surgical intervention after an initial failed endoscopic retrograde cholangiopancreatography (ERCP). An elderly female patient in her early 90s arrived at the emergency department with severe cramping pain localized to the right upper quadrant of her abdomen, progressively intensifying over several weeks.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Introduction: Duplication of the gallbladder is a rare congenital malformation associated with the development of cholelithiasis. It increases the risk of iatrogenic bile duct injury during cholecystectomy and can lead to symptom recurrence if missed. Although preoperative imaging is helpful, detection rates are around 50 %.
View Article and Find Full Text PDFRev Esp Enferm Dig
January 2025
Digestive Diseases, Hospital Universitario Fundación Jiménez Díaz, España.
The duodenal diverticulum is a relatively frequent entity whose diagnosis has been increased over time with the development of new diagnostic and exploratory techniques. Periampullary diverticula (PAD) were classified as type 1, 2, or 3 according to the position of the major papilla from the endoscopic view: type 1, the major papilla was located inside of the diverticula; type 2, the major papilla was located at the edge of the diverticula; type 3, the major papilla was located outside of the diverticula. Complications of duodenal diverticula include ulceration, bleeding, perforation and inflammation with intestinal obstruction.
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November 2024
Radiology, Government Medical College & Hospital, Jammu, Jammu, IND.
Introduction: Obstructive jaundice resulting from a duodenal diverticulum is known as Lemmel syndrome. Lemmel syndrome should be included in the differential diagnosis in patients presenting with obstructive jaundice in the absence of choledocholithiasis, mass, or a stricture.
Aims And Objectives: To describe the computed tomography (CT) findings in patients with Lemmel syndrome.
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