Two Cases of a Perforated Duodenal Diverticulum

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  • 十二指腸憩室穿孔の2例

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Case 1 was a woman in her seventies who was admitted to our hospital complaining of epigastralgia. An abdominal computed tomography （CT） scan showed a duodenal diverticulum and air in the retroperitoneum. She was diagnosed as having perforation of the duodenal diverticulum. She was treated conservatively because she had minimal fluid collection in the retroperitoneum and the onset was quite recent. Her symptoms reduced and she was discharged from the hospital on day 19. Case 2 was a woman in her seventies who was admitted because of abdominal pain which has lasted for three days. An abdominal CT scan showed a duodenal diverticulum and air and fluid collection in the retroperitoneum. She was diagnosed as having a perforated duodenal diverticulum. We performed an emergency laparotomy, direct closure of the perforated diverticulum, an omental patch, gastrojejunostomy, and drainage of the duodenum and biliary tract. She recovered without complications and was discharged from the hospital on day 20. Perforation of a duodenal diverticulum is a relatively rare condition；abdominal CT is useful for diagnosing this disease. Conservative management is possible if the condition is diagnosed at an early stage.

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