Surgical approach for duodenal diverticulum perforation: A case report
| Autor: | Iyad Al Mohtar, Etienne El-Helou, Khaled Rahal, Faisal Houcheimi, Walid Ambriss, Hasan Atwi, Marwan Bahmad, Nisreen Maanieh, Mouhamad Hazim, Abdel Rahman Amiry, Alaa Kansoun |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Abdominal pain Duodenal diverticulum Perforation (oil well) Perfortation GI Gastrointestinal digestive system Lebanese 03 medical and health sciences 0302 clinical medicine Pneumoperitoneum Case report Medicine DD duodenal diverticulum business.industry General surgery medicine.disease digestive system diseases PCT Procalcitonin medicine.anatomical_structure 030220 oncology & carcinogenesis Diverticulectomy Duodenum CRP C-reactive protein Conservative management 030211 gastroenterology & hepatology Surgery ERCP endoscopic retrogradecholangiograpgy Differential diagnosis Presentation (obstetrics) medicine.symptom business Complication NG Naso-Gastric Diverticulum |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Duodenal diverticula is mostly found incidentally and it rarely complicates by perforation. • Treatment is only indicated in complicated duodenal diverticula. • Micro perforation in the absence of systemic signs are better treated with conservative management. • Among surgical options diverticulectomy and single layer closure was performed. • Other surgical intervention could involve segmental duodenectomy or pylorus-preserving duodeno-pancreatectomy. Introduction Duodenal Diverticula is not uncommon and it is mostly found in the 2nd part of the duodenum. Despite the fact that it is mostly found incidentally, it can complicate however it rarely complicates by perforation. Treatment is indicated only in complicated cases and it is divided into conservative and surgical arms. Presentation of case It is a case of 78 years old Lebanese female that was diagnosed intra-operatively with a perforated duodenal diverticulum after presenting with post prandial abdominal pain, distention and pneumoperitoneum on imaging. Our case was consistent with previous reports where the diverticulum occurred in the second part of the duodenum. We opted for primary resection of the diverticulum and over-sewing. Moreover, patient had an uneventful post-operative course and progressed gradually to be discharged on day 10. Conclusion Our case aims to draw attention to a rare complication of duodenal diverticula and to widen the differential diagnosis of pneumoperitoneum thus concluding about the better treatment option. Previous reports show that proper management is still a controversial topic; however surgical approach is indicated in case of systemic signs. |
| Databáze: | OpenAIRE |
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