Abstract
Duodenal diverticulum is usually detected at the 2nd portion without symptoms. We experienced a rare case of duodenal diverticular perforation at the 4th portion. A 61-year-old woman was admitted to our hospital due to abdominal pain with severe inflammation.
Abdominal X-ray revealed neither niveau nor free air. Abdominal CT showed intra-mesenteric abnormal air. Upper gastrointestinal radiography showed a duodenal diverticulum at the 3rd portion and contrast medium leakage outside intestinal tract.
From an emergency operation, a perforated duodenal diverticulum of 1 cm diameter at the 4th portion was confirmed on the left-dorsal side of superior mesenteric artery near the Treitz ligament, and an abscess was formed, extending, from the perforated portion to the intra-mesenteric area of the small intestine. After drainage of the abscess, debridement and simple closure of the diverticulum were performed. The patient was discharged on the 36th postoperative day without major complication.
