Duodenal Divertikül Perforasyonu: Nadir Bir Olgu Sunumu ve Literatür İncelemesi

Yıl 2024, , 79 - 84, 28.04.2024

Eren Ozan Yıldız , Ahmet Serkan İlgun

https://doi.org/10.29058/mjwbs.1364345

Öz

Amaç: Duodenal divertikül gastrointestinal sistemde en sık görülen ikinci divertikül kesitidir ancak
perforasyon nadirdir. Sıklıkla tesadüfen teşhis edilir ve çok az klinik kanıtı vardır. Duodenal divertikül
perforasyonu için kesin bir tedavi stratejisi yoktur. Amacımız olgu sunumumuz aracılığıyla son 10
yılda yayınlanan perfore duodenal divertikül vakalarını tespit etmek ve farklı tedavi yaklaşımlarını
değerlendirmektir.
Olgu Sunumu: Merkezi sinir sistemi (MSS) tümörü bulunan 58 yaşında bir erkek hastaya, perfore
duodenal divertikülü tanısı konuldu. Hastanın karın ağrısı ve görüntülemede pnömoperitonyum
mevcuttu. Hastaya omental yama, pilorun çıkarılması, retrokolik gastrojejunostomi ve tüp duodenostomi
ile cerrahi olarak tedavi edildi. Hasta ameliyat sonrası 10. günde ex oldu.
Sonuç: Duodenal divertikül perforasyonu nadir fakat ölümcül bir durumdur. BT tanıda faydalıdır.
Hastanın septik durumu yoksa konservatif olarak takip edilebilir. Ancak hastanın septik bir durumu
varsa ameliyat gerekebilir. Perforasyon yerine ve özelliklerine göre cerrahi seçenekler belirlenmelidir.

Anahtar Kelimeler

Duodenum, perforasyon, duodenal divertikül

Duodenal Diverticulum Perforation: A Rare Case Report and Review of the Literature

Öz

Aim: Duodenal diverticulum is the second most common diverticulum section in the gastrointestinal
system, but perforation is rare. It is frequently diagnosed incidentally and has little clinical evidence.
There are no certain treatment strategies for duodenal diverticulum perforation.
Our aim is to identify perforated duodenal diverticulum cases published in the last 10 years through our
case report and to evaluate different approaches to treatment.
Case Report: A 58-year-old male was diagnosed central nervous system (CNS) tumor with a perforated
duodenal diverticulum. Our case presented with abdominal pain and pneumoperitoneum on imaging.
The patient was treated surgically with an omental patch, pyloric exclusion, retrocolic gastrojejunostomy,
and tube duodenostomy. The patient died on the 10th postoperative day.
Conclusion: Duodenal diverticulum perforation is a rare but fatal condition. CT is useful in diagnosis.
If the patient is not in a septic condition, it can be followed conservatively. However, if the patient is
in a septic condition, surgery may be required. Surgical options should be determined based on the
perforation site and characteristics.

Anahtar Kelimeler

Duodenum, perforation, duodenal diverticulum

Kaynakça

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