From the Research
A duodenal diverticulum is an outpouching of all or partial layers of the duodenal wall, which can be acquired or congenital, and is usually located in the second portion of the duodenum.
Definition and Location
- A duodenal diverticulum is a small pouch or sac that bulges outward from the wall of the duodenum, which is the first part of the small intestine.
- These pouches form when the inner lining of the duodenum pushes through weak spots in the intestinal wall.
- Most duodenal diverticula are acquired rather than congenital, becoming more common as people age, particularly after age 50, as noted in 1.
- They typically occur near the ampulla of Vater where the bile and pancreatic ducts enter the duodenum.
Symptoms and Complications
- Most duodenal diverticula are asymptomatic and discovered incidentally during imaging or endoscopic procedures.
- However, some may cause symptoms like abdominal pain, nausea, vomiting, or complications such as bleeding, inflammation (diverticulitis), perforation, or biliary obstruction, as discussed in 2, 3.
- The exact cause of duodenal diverticula is not fully understood, but they likely develop due to a combination of increased intestinal pressure and weakening of the intestinal wall with age.
Diagnosis and Treatment
- Imaging examinations, such as computed tomography (CT) scans, play a crucial role in the diagnosis of duodenal diverticula, as mentioned in 4.
- Treatment is usually not necessary for asymptomatic diverticula.
- When symptoms occur, they are typically managed with antibiotics for infection, pain control, and sometimes endoscopic or surgical intervention for severe complications, as noted in 5.
- Surgical intervention, such as diverticulectomy with a combination of Cattell-Braasch and Kocher maneuvers, may be necessary for symptomatic duodenal diverticula, particularly those located in the third part of the duodenum.