Perforated duodenal diverticulitis: a report of three cases.

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.