J Korean Surg Soc.  2009 Feb;76(2):123-126. 10.4174/jkss.2009.76.2.123.

Intraluminal Duodenal Diverticulum Causing Chronic Gastrointestinal Bleeding in Adults

Affiliations
  • 1Department of Surgery, Pusan National University Hospital, Busan, Korea.
  • 2Department of Surgery, Pusan National University Yangsan Hospital, School of Medicine, Pusan National University, Busan, Korea. dr-cyh@hanmail.net

Abstract

Intraluminal duodenal diverticulum (IDD), 'windsock web', is known to be a rare congenital condition observed in the adult, sometimes causing an obstruction, pancreatitis, and acute/chronic bleeding. We experienced a case of intraluminal duodenal diverticulum associated with a chronic gastrointestinal bleeding in a young adult man. This condition was identified during the examination for an intermittent melena through a gastroduodenoscopy and an upper gastrointestinal series, revealing a lesion between the second and third portion of the duodenum. Laparotomy was planned for its management. A duodenotomy and excision of the diverticulum was performed and showed good results.

Keyword

Intraluminal duodenal diverticulum; Duodenotomy; Excision

MeSH Terms

Adult
Diverticulum
Duodenum
Hemorrhage
Humans
Laparotomy
Melena
Pancreatitis
Young Adult

Figure

  • Fig. 1 Endoscopic findings show two openings in the duodenal lumen, an opening of the lesion (A) and true duodenum (B) at the left side, also showing a cystic mass at the second portion of duodenum at the right. It also shows an ulcerative lesion with minor bleeding.

  • Fig. 2 UGI (upper gastrointestinal) series shows a finding of intraluminal contrast filling with a radiolucent halo.

  • Fig. 3 Abdominal CT (computed tomography) shows an abnormal finding mimicking intussusceptions in the lumen and a sac-like, intraluminal projection.

  • Fig. 4 At the operative field, there are no abnormal findings, grossly.

  • Fig. 5 Two intraluminal diverticulums, sac-like projection were found around the Vater of ampulla, catheterization through its opening.

  • Fig. 6 After excision of diverticulum, the mucosal defect is repaired with interrupted absorbable suture.


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