A Case Involving a Diverticulectomy on the Third Portion of Duodenum

Abstract

A 65-year-old woman had undergone a laparoscopic cholecystectomy for cholecystitis eighteen years previously, and a duodenal diverticulum was detected by an upper gastrointestinal (GI) series at that time. Seven years previously, she had complained again of epigastric pain which was diagnosed as pancreatitis. Thus, we thought that the duodenal diverticulum was the cause of those symptoms, and decided to perform a diverticulectomy. As the preoperative exams, an upper GI series identified a 5 cm diameter diverticulum on the third portion of the duodenum, although there were no compressive findings of the pancreatic and bile ducts based on magnetic resonance cholangiopancreatography MRCP and disseminated intravascular coagulation (DIC)-CT findings. Firstly, we started to conduct a laparoscopic diverticulectomy, then we converted to open surgery for a duodenojejunostomy. She has had no symptoms for 18 months after surgery. Duodenal diverticulum rarely causes complications such as perforation, bleeding, diverticulitis, Lemmel syndrome, and so on. There is no definite treatment strategy. We report herein on a case of diverticulectomy on the third portion of duodenal diverticulum with a literature review.