Rodríguez-Infante S, Zamora-García AC, Alcaraz-Silva JA, Sánchez-Rosado RR

Language: Spanish
References: 12
Page: 20-24
PDF size: 305.44 Kb.

ABSTRACT

Introduction: juxtapapillary duodenal diverticula (JDD) represent a rare entity, posing a significant diagnostic challenge due to the variety of common symptoms they present such as nausea, vomiting, recurrent and intermittent episodes of abdominal pain. Timely diagnosis is crucial to prevent complications, although rare, they are associated with high mortality, representing a challenge for medical management. Two clinical cases with this pathology are presented, highlighting the diagnostic challenge. Clinical cases: first case: a 70-year-old woman with multiple episodes of recurrent abdominal pain, sensation of gastric fullness and intermittent gastro-biliary vomiting who received treatments for dyspepsia and biliary colic that were ineffective and whose diagnostic approach revealed the presence of choledocholithiasis. She underwent endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy, stone extraction, and evidence of JDD. Second case: an 86-year-old woman with episodes of intermittent abdominal pain, without findings in previous diagnostic approaches, receiving various ineffective treatments for gastroenteritis and acid-peptic disease. In her diagnostic approach, dilation of the common bile duct without evidence of stones was found. She underwent duodenoscopy and ERCP, where JDD with abundant food residue was identified and removed, leading to evident clinical improvement. Conclusion: despite being rare, it is essential to consider JDD in the differential diagnoses of abdominal pain in patients whose etiology remains unclear. The importance of considering them as a diagnostic suspicion during medical evaluation is emphasized, as well as opting for precise interventions to prevent associated complications.

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