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A duodenal diverticulum is a commonly encountered entity in gastrointestinal radiology with a wide variety of appearances. The purpose of this review is to describe the normal anatomy and embryology of the duodenum, discuss the differences between a true versus intraluminal duodenal diverticulum, and to highlight the normal appearance, potential complications, and imaging pitfalls of duodenal diverticula., (Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Aim: A series of rare complicated duodenal diverticula were reported with emphasis on causes for misdiagnosis., Material and Methods: Patients with a discharge diagnosis of complicated duodenal diverticulum were retrospectively obtained. Computed tomographic (CT) reports and findings were reviewed., Results: Complications consisted of diverticulitis (n=2), perforation (n=7), or obstructive cholangitis (n=2). CT imaging demonstrated a duodenal diverticular structure with findings due to the kind of complications. At the time of CT interpretation, a complicated duodenal diverticulum was suspected in 5 out of 11 patients., Conclusion: Awareness of the duodenal diverticulum and complications may improve the diagnostic value of CT in this setting., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: Duodenal diverticuli are present in up to 22% of the population. However, perforation of a duodenal diverticulum with spillage of enteric contents into the retroperitoneum is rare., Methods: We report three cases of perforated duodenal diverticulitis., Results: Clinical presentations varied widely from patients with acute abdominal findings and generalized sepsis to a patient with mild symptoms of abdominal discomfort. CT scanning was the imaging modality used to make an accurate diagnosis. Treatment approaches for the most stable patient included nonoperative management with antibiotics, bowel rest and parenteral alimentation, while the less stable patients underwent definitive surgery with complete diversion of gastric contents and biliary flow from the affected area of duodenum., Conclusions: This report highlights the salient issues in the presentation, diagnosis and modern management of patients with this potentially catastrophic disease., (Copyright (c) 2005 S. Karger AG, Basel.)

The authors share their experience with the treatment of 18 patients. Most of them (10) sought medical aid for complications. The authors consider resection of the stomach to be ineffective for the exclusion of the diverticulum of the duodenum. The operation of choice is thought by them to be an exclusion of the duodenum from the passage of food. Stomach resection after Ridiger is thought to be effective for a combination of the diverticulum and duodenal ulcer. There were no complications or immediate lethal outcomes.

The duodenal diverticulum, except for occasional findings, are diagnosed by their complications, these are found in 10% of the cases and they are: 1) diverticulitis 2) haemorrhage 3) mechanic disturbances 4) perforation 5) obstruction 6) malabsorption syndrome. The case that motivated our communication appeared as a massive haemorrhage, that was medically treated considering the high mortality, rate of the surgical procedures. As the duodenal diverticuli can be cause of acute or chronic digestive haemorrhage, and this is frequently due to the erosion produced, by the heterotopic gastric mucosae, we consider that its demonstration with technetium 99 can be a valuable diagnostic method, as has already been demonstrated in other pathologies that present heterotopic mucosae, and as has been demonstrated in our case.

The work generalized an experience with the treatment of 747 patients with diverticula of the duodenum. Operations were performed on 326 of them (43.6%). In 172 patients the diverticula were associated with other diseases of organs of the abdominal cavity. Such patients were subjected to associated operations. The dependence of the clinical picture of inflamed diverticula on their localization is described. The author determines the surgeons' strategy, indications and volume of the surgery in different localizations of the diverticula. A new operation of exclusion of the duodenum allowing the postoperative lethality to be decreased from 5.5% to 1% was developed and introduced into practice.