Martínez ZJJ, Correa RJM, Visag CV, García VD, Reyes EL

Language: Spanish
References: 8
Page: 18-21
PDF size: 200.87 Kb.

ABSTRACT

Background. First described by Chomel, a French pathologist, in 1710, diverticula of the duodenum are relatively common, representing the second most common site for diverticulum formation after the colon. The incidence is varied depending on the age of the patient and the method of diagnosis. Localization of the diverticular in the second portion of the duodenum is most commonly in the second part of the duodenum usually within 2.5 cm of the ampulla. Diagnosis is made by endoscopy, contrast X- rays of the upper gastrointestinal tract, selective arteriography and as a transoperative finding. The objective of this study was to analyze the clinical presentation of duodenal diverticulum diagnosis and treatment. Clinical case. We report the case of an 61-year-old male presenting with down digestive tract hemorrhage due to diverticulum located in the second portion of the duodenum. Diagnosis was made with endoscopy study and confirmed with barium esophagus/gastroduodenal series. Discussion. It is important thing to remember is that the overwhelming majority of duodenal diverticula are asymptomatic and are usually noted incidentally. Symptoms are generally vague. Patients may present with chronic complaints such as stasisinduced steatorrhea and intractable abdominal pain, or with acute symptoms gastrointestinal bleeding, perforation with high mortality. Conclusion. Down digestive tract hemorrhage can be the presentation of diverticula duodenum.

REFERENCES

1. Beauchamp RD, Evers BM, Mattox KL. Small intestine. Sabiston. Textbook of Surgery. Canada: Elsevier; 2008, p. 1318-20.

2. Mehdi A. Closset J, et al. Duodenal diverticula diagnosis and management of complicated forms: report of two clinical cases and review of the literature. Kao Hsinung I Hsueh Ko Hsueh Tsa Chic 1993; 9(8): 488-93.

3. Chuang JH, Chan HM, et al. Enterolith ileus as a complication of duodenal diverticulosis-one case report and review of the literature. Surgery 1988; 104(1): 74-8.

4. Beachley MC, Lankaun CA. Inflammated duodenal diverticulum. Preoperative radiographic diagnosis. Am J Dig Dis 1977; 22(2): 149-54.

5. Brzot-Andersen B, Amstrup JH. Duodenal diverticulum. Report of a case and review of published cases. GEN 1977; 31(4): 325-34.

6. Duarte B, Nagy KK, et al. Perforated duodenal diverticulum. Br J Surg 1992; 79(9): 877-81.

7. Balkissoon J, Balkissoon B, Leffal LD Jr, et al. Massive upper gastrointestinal bleeding in a patient with a duodenal diverticulum: a case report and review of the literature. J Natl Med Assoc 1992; 84: 365-7.

8. Yin WY, Chen HT, Huang SM, et al. Clinical anaylsis and literature review of massive duodenal diverticular bleeding. World J Surg 2001; 25; 848-55.