Differences in Clinical Characteristics between Juxtapapillary Duodenal Diverticulum and Intradiverticular Papillae

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Purpose: To clarify the difference in clinical characteristics between juxtapapillary duodenal diverticulum (JPDD) and intradiverticular papillae (IDP) patients, we performed a clinical study comparing these 2 groups. Methords: Patients with duodenal diverticula located less than 2 cm from the papilla Vateri were divided into 2 groups [groups A (10 JPDD patients: 5 men and 5 women, 47 to 84 years of age; mean age: 67.3 years) and B (6 IDP patients; 4 men and 2 women, 52 to 89 years of age; mean age: 70.3 years)]. We retrospectively assessed differences in the clinical characteristics between groups A and B. Results: Clinical symptoms: Abdominal pain was detected in all patients in both groups. Fever and jaundice were more frequent in group B than A. Laboratory data (AST, ALT, AlP, LAP,γGTP, amylase, bilirubin) on admission: Abnormal values were more common in group B than group A. The frequency of the elevation of the serum values, such as ALP, LAP, and γGTP in group A was significantly lower than that in group B (p=0.010). Size of the diverticulum: Patients in group A had a smaller diverticulum than those in group B. Diameter of the common bile duct: Patients in group A had a narrower bile duct than those in group B. Sites of stones: Choledocholithiasis was more frequent in group B than group A. Kinds of stone: Calcium bilirubinate stones were more common in group B than group A. Bactobilia in the gallbladder was more frequent in group B than group A. Conclusions: Patients with IDP showed abnormal data in their clinical characteristics compared with those with JPDD. Especially, abnormal data on ALP, LAP andγGTP were clearly found in patients with IDP compared with those with JPDD.