2021 Volume 41 Issue 7 Pages 543-546
A 58-year-old man was admitted to our hospital for right upper quadrant pain. He had undergone distal gastrectomy and Roux-en-Y reconstruction and cholecystectomy two years earlier. Findings of abdominal computed tomography（CT）were suggestive of duodenal diverticulitis with an enterolith. Endoscopy revealed a diverticulum with an impacted enterolith. Following removal of the enterolith using a gripping forceps, wall thinning and partial necrosis of the diverticulum were observed, and we performed a laparotomy. Because the diverticulum on the outside of the descending duodenum was fragile and easily torn, excision of the diverticulum was difficult; therefore, the mucosa at the base of the diverticulum was closed by sutures and wrapped around the diverticular wall. A 12 Fr gastric tube was inserted from the duodenal stump and a T-tube was placed in the common bile duct for decompression. Although he developed wound infection and liver dysfunction, he was treated conservatively and was discharged on the 35th postoperative day. We report the case of a patient with duodenal diverticulitis with an enterolith that developed after gastrectomy and Roux-en-Y reconstruction, who showed a good course after sewing and decompression.
