A Rare Cause of Acute Abdomen: Perforation of Duodenal Diverticulum Containing Ectopic Pancreatic Tissue

Year 2011, Volume: 2011 Issue: 3, 335 - 337, 01.03.2011

Yavuz Özdemir Bülent Güleç İlker Sücüllü Ali İlker Filiz

https://doi.org/10.5174/tutfd.2009.03234.5

Abstract

Perforation is a rare but serious complication of a duodenal diverticulum and often presents itself with nonspecific symptoms and signs. Ectopic pan-creatic tissue within a duodenal diverticulum is another rare situation. In this article, we report a case of an 87 year-old woman who presented with spontaneous perforation of the duodenal diverticulum. Operative resection and simple closure of the duodenum was performed. Ectopic pancreatic tissue was observed within the diverticulum at histological evaluation.

Keywords

Duodenal diverticulum, perforation, acute abdomen, ectopic pancreatic tissue

A Rare Cause of Acute Abdomen: Perforation of Duodenal Diverticulum Containing Ectopic Pancreatic Tissue

Abstract

Perforation is a rare but serious complication of a duodenal diverticulum and often presents itself with nonspecific symptoms and signs. Ectopic pan-creatic tissue within a duodenal diverticulum is another rare situation. In this article, we report a case of an 87 year-old woman who presented with spontaneous perforation of the duodenal diverticulum. Operative resection and simple closure of the duodenum was performed. Ectopic pancreatic tissue was observed within the diverticulum at histological evaluation.

Keywords

Duodenal diverticulum, perforation, acute abdomen, ectopic pancreatic tissue

References

• Graur F, Bala O, Bodea R, Geczi-Toth I, Vlad L, Iancu C. Laparo- scopic resection of duodenal diverticulum. A case report. Rom J Gastroenterol 2005;14:405-8.
• Bergman S, Koumanis J, Stein LA, Barkun JS, Paraskevas S. Duo- denal diverticulum with retroperitoneal perforation. Can J Surg 2005;48:332.
• Yokomuro S, Uchida E, Arima Y, Mizuguchi Y, Shimizu T, Kawahi- gashi Y, et al. Simple closure of a perforated duodenal diverticu- lum: a case report. J Nihon Med Sch 2004;71:337-9. [CrossRef]
• Marhin WW, Amson BJ. Management of perforated duodenal diverticulum. Can J Surg 2005;48:79-80.
• Afridi SA, Fichtenbaum CJ, Taubin H. Review of duodenal diver- ticula. Am J Gastroenterol 1991;86:935-8.
• Duarte B, Nagy KK, Cintron J Perforated duodenal diverticulum. Br J Surg 1992;79:877-81. [CrossRef]
• Franzen D, Gurtler T, Metzger U. Solitary duodenal diverticulum with enterolith as a rare cause of acute abdomen. Swiss Surg 2002;8:277-9. (Article in German) [CrossRef]
• Volchok J, Massimi T, Wilkins S, Curletti E. Duodenal diverticu- lum: case report of a perforated extraluminal diverticulum con- taining ectopic pancreatic tissue. Arch Surg 2009;144:188-90. [CrossRef]
• Lida F. Transduodenal diverticulectomy for periampullar diver- ticula. World J Surg 1979;3:135-6. [CrossRef]
• Christodoulidis G, Zacharoulis D, Barbanis S, Katsogridakis E, Hatz- itheofilou K. Heterotopic pancreas in the stomach: a case report and literature review. World J Gastroenterol 2007;13:6098-100. [CrossRef] 337 2011; 28: 335-7 Özdemir et al.
• Acute Abdomen and Duodenal Diverticula
• D’Alessio MJ, Rana A, Martin JA, Moser AJ. Surgical manage- ment of intraluminal duodenal diverticulum and coexisting anom- alies. J Am Coll Surg 2005;201:143-8. [CrossRef]
• Osnes M, Lİotveit T, Larsen S, Aune S. Duodenal diverticula and their relationship to age, sex, and biliary calculi. Scand J Gastro- enterol 1981;16:103-7.
• Armstrong CP, Kinig PM, Dixon JM, Macleod IB. The clinical sig- nificance of heterotopic pancreas in the gastrointestinal tract. Br J Surg 1981;68:384-7. [CrossRef]
• Condon RE. Disorders of the stomach and duodenum. In: Nyhus LM, Wastell C, editors. Surgery of the stomach and duodenum. 4th ed. Boston: Little Brown and Company; 1986. p. 573-625.
• Psathakis D, Utschakowski A, Muller G, Broll R, Bruch HP. Clinical significance of duodenal diverticula. J Am Coll Surg 1994;178:257-60.
• Andromanakos N, Filippou D, Skandalakis P, Kouraklis G, Kosta- kis A. An extended retroperitoneal abscess caused by duodenal diverticulum perforation: report of a case and short review of the literature. Am Surg 2007;73:85-8.
• Papalambros E, Felekouras E, Sigala F, Kiriakopoulos A, Gi- annopoulos A, Aessopos A, et al. Retroperitoneal perforation of a duodenal diverticulum with colonic necrosis-report of a case. Zentralbl Chir 2005;130:270-3. [CrossRef]
• Goodman P, Raval B, Zimmerman G. CT diagnosis of perforated duodenal diverticulum. Clin Imaging 1989;13:321-2. [CrossRef]
• Juler GL, List JW, Stemmer EA, Connolly JE. Perforating duode- nal diverticulitis. Arch Surg 1969;99:572-8.
• Van Beers B, Trigaux JP, De Ronde T, Melange M. CT findings of perforated duodenal diverticulitis. J Comput Assist Tomogr 1989;13:528-30. [CrossRef]
• Tsukamoto T, Ohta Y, Hamba H, Sasaki Y, Tokuhara T, Kubo S, et al. Perforated duodenal diverticulum: report of two cases. Hepa- togastroenterology 1999;46:1755-8.