Traumatic Perforation of the Duodenal Diverticulum: A Case Report

외상후 발생한 십이지장 게실 천공 1예

  • Kim, Ho Hyun (Trauma Center of Pusan National University Hospital) ;
  • Park, Yun Chul (Division of Trauma Surgery, Department of Surgery, Chonnam National University Medical School) ;
  • Lee, Dong Kyu (Trauma Center of Mokpo Hankuk Hospital) ;
  • Park, Chan Yong (Division of Trauma Surgery, Department of Surgery, Chonnam National University Medical School) ;
  • Kim, Jae Hun (Trauma Center of Pusan National University Hospital) ;
  • Kim, Yeong Dae (Trauma Center of Pusan National University Hospital) ;
  • Kim, Jung Chul (Division of Trauma Surgery, Department of Surgery, Chonnam National University Medical School)
  • 김호현 (부산대학교병원 외상센터) ;
  • 박윤철 (전남대학교 의과대학 외과학교실 외상외과) ;
  • 이동규 (목포한국병원 외상센터) ;
  • 박찬용 (전남대학교 의과대학 외과학교실 외상외과) ;
  • 김재훈 (부산대학교병원 외상센터) ;
  • 김영대 (부산대학교병원 외상센터) ;
  • 김정철 (전남대학교 의과대학 외과학교실 외상외과)
  • Received : 2013.01.28
  • Accepted : 2013.04.17
  • Published : 2013.06.30

Abstract

A duodenal diverticulum is a frequent abnormality that is usually diagnosed incidentally. Clinical manifestations usually mimic those of highly-varied entities. Among the complications of a duodenal diverticulum, perforation is fairly rare; rupture due to blunt trauma is even rarer, and no cases have been reported in Korean literature. We report the case of a 61-year-old male patient who presented with a perforated duodenal diverticulum after a blunt trauma. We also review the existing literature.

Keywords

References

  1. Harford WV. Diverticula of the hypopharynx and esophagus, the stomach and small bowel. In: Feldman M, Scharschmidt BF, Sleisenger MH, (Ed). Sleisenger and Fordtran's Gastrointestinal and Liver Diseases. 6th (Ed). Philadelphia: WB Saunders Co 1998; 1: 313-6.
  2. Duarte B, Nagy KK, Cintron J: Perforated duodenal diverticulum. Br J Surg 1992; 79: 877-81. https://doi.org/10.1002/bjs.1800790907
  3. Park H, Ko KH, Kim JK, Choi HY, Hong SP, Hwang SK, et al. Duodenal Perforation due to Hemoclipping for the Dieulafoy's Lesion in a Duodenal Diverticulum. Korean J Gastrointest Endosc 2005; 30: 160-3.
  4. Jee SB, Kim SS, Jun KH, Kim W, Park KS, Jeon HM. Perforated Duodenal Diverticulum after Distal Subtotal Gastrectomy and Billorth II Gastrojejunostomy. J Korean Gastric Cancer Assoc 2006; 6: 52-6. https://doi.org/10.5230/jkgca.2006.6.1.52
  5. Thorson CM, Paz Ruiz PS, Roeder RA, Sleeman D, Casillas VJ. The perforated duodenal diverticulum. Arch Surg 2012; 147: 81-8. https://doi.org/10.1001/archsurg.2011.821
  6. Macari M, Lazarus D, Israel G, Megibow A. Duodenal diverticula mimicking cystic neoplasms of the pancreas: CT and MR imaging findings in seven patients. AJR Am J Roentgenol. 2003; 180: 195-9. https://doi.org/10.2214/ajr.180.1.1800195
  7. Juler GL, List JW, Stemmer EA, Connolly JE. Perforating duodenal diverticulitis. Arch Surg 1969; 99: 572-8. https://doi.org/10.1001/archsurg.1969.01340170024006
  8. Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR, Gennarelli TA, et al. Organ injury scaling, II: Pancreas, duodenum, small bowel, colon, and rectum. J Trauma 1990; 30: 1427-9. https://doi.org/10.1097/00005373-199011000-00035
  9. Biffl WL. Duodenum and Pancreas. In: Mattox KL, Moore EE, Feliciano DV. Trauma. 7th ed. New York: McGraw-Hill, 2012: 610-3.
  10. Marhin WW, Amson BJ. Management of perforated duodenal diverticula. Can J Surg 2005; 48: 79-80.
  11. Ames JT, Federle MP, Pealer KM. Perforated duodenal diverticulum: clinical and imaging finding in eight patients. Abdom Imaging 2009; 34: 135-9. https://doi.org/10.1007/s00261-008-9374-x
  12. Lee HH, Hong JY, Oh SN, Jeon HM, Park CH, Song KY. Laparoscopic diverticulectomy for perforated duodenal diverticulum: a case report. J Laparoendosc Adv Surg Tech A 2010: 20: 757-60. https://doi.org/10.1089/lap.2010.0346
  13. Chen CF, Wu DC, Chen CW, Hsieh JS, Chen CY, Wang JY. Successful management of perforated duodenal diverticulitis with intra-abdominal drainage and feeding jejunostomy: a case report and literature review. Kaohsiung J Med Sci 2008; 24: 425-9. https://doi.org/10.1016/S1607-551X(08)70167-0
  14. Rathore MA, Andrabi SI, Najfi SM, Chaudhry Z, Chaudhry AM. Injuries to the duodenum-prognosis correlates with body Injury Severity Score: a prospective study. Int J Surg 2007; 5: 388-93. https://doi.org/10.1016/j.ijsu.2007.05.006
  15. Huerta S, Bui T, Porral D, Lush S, Cinat M. Predictors of morbidity and mortality in patients with traumatic duodenal injuries. Am Surg 2005; 71: 763-7.