hematemesis and melena. The patient underwent
upper digestive endoscopy that showed gastric inflammation and edematous
inflamed first part of the duodenum with apparent duodenal diverticulum.
NOTES:
Definitions:Duodenal diverticula #: outpouchings from the duodenal wall.
They result from mucosal prolapse or the prolapse of the
entire duodenal wall.
They can be seen at any point in the duodenum. Duodenal
diverticula are commonly located along the medial
wall of the second, or superior wall of the third, part of the duodenum.
Types:
There are two types of duodenal diverticula:
Primary diverticulum #
Secondary diverticulum #
A primary duodenal diverticulum: a prolapse of mucosa through the muscularis propria. They usually happen within the 2nd part (62%) and less commonly in the 3rd (30%) and fourth (8%) parts.
They are rare in the 1st part.
A secondary duodenal diverticulum #: prolapse of the entire
duodenal wall and almost invariably occurs in the 1st part of the duodenum.
These are true diverticula #.
It usually occurs secondary to duodenal or
periduodenal inflammation, e.g., from
previous ulcer disease.
Prevalence:
The duodenum is the most frequent site of
diverticulum formation after the colon.
Complications:
The complications of duodenal diverticula are similar to those of other
gastrointestinal diverticula (bleeding, inflammation, obstruction, and
perforation).
In about 30% of the cases, bleeding is the main complication, while perforation and abscess formation is uncommon.
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