A Case of Intraluminal Duodenal Diverticulum Treated by Curative Surgical Resection

Abstract

We report a case of intraluminal duodenal diverticulum (IDD) that was treated by surgical resection. A 24-year-old male was treated conservatively for acute pancreatitis, but the disease recurred 3 months later. Thus, he was referred to our hospital for a detailed examination. CT showed a cystic lesion in the lumen of the descending and horizontal portion of the duodenum. Upper gastrointestinal endoscopy showed a false lumen with a blind end at the anal side near the ampulla of Vater. An upper gastrointestinal series showed a gastrografin-filled pear-shape sac of approximately 30 mm surrounded by a well-defined halo zone. Resection of IDD and cholecystectomy with C-tube drainage under laparotomy was performed under a preoperative diagnosis of relapsing pancreatitis caused by IDD. The postoperative course was uneventful, and there has been no recurrence of pancreatitis during a follow-up period of 10 months. Although endoscopic resection is reported to be useful for IDD, resection of IDD with laparotomy was performed based on the size of the IDD and the locational relationship between the IDD and the ampulla of Vater. Herein, we present a case of IDD and discuss the treatment options with a review of the literature.