Duodenal diverticulum

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Classification according to ICD-10
K57.0 Diverticulosis of the small intestine with perforation and abscess
K57.1 Diverticulosis of the small intestine without perforation or abscess
ICD-10 online (WHO version 2019)

Duodenal diverticula are bulges ( diverticula ) of the intestinal wall on the duodenum . Most of the duodenal diverticula develop in the direction of the pancreas , so they can be found on the concave side of the C-loop.

There are also rarely intraluminal or intramural duodenal diverticula that protrude into the intestinal canal or are found in the wall itself. These rare forms are congenital malformations, have arisen from mucosal duplication (doubling of the mucous membrane ) and can lead to a complete relocation of the small intestine. In terms of evolution, they are related to duodenal atresia .

frequency

The frequency is stated differently depending on the patient population. According to section studies , they are found in around 20% of all cases; Endoscopists see it with 10% next to the papilla ( iuxtapapillary ) when they z. B. have to examine the duodenum carefully on the occasion of an ERCP to find the junction of the bile duct. The duodenal diverticulum is likely to become more common with age. Men and women are equally affected. The exact cause of their formation is unknown.

Medical importance

As a rule, duodenal diverticula do not cause any symptoms. They only interfere with the ERCP and can make this examination difficult or impossible.

Complications

The duodenal diverticulum is rarely to blame as the cause of bleeding in the digestive tract . Duodenal diverticula can also become complicated and symptomatic due to inflammation, perforation , ileus, pancreatitis and blockage of the bile duct. Thickened and hardened intestinal contents are very rarely found in the diverticulum ( enterolith ).

diagnosis

Usually, a duodenal diverticulum is discovered by chance during an endoscopy , computed tomography, or laparotomy because it is usually clinically silent.

therapy

Very rarely does a duodenal diverticulum have to be operated on.

See also

literature

  • Ludwig Köhl: A contribution to the knowledge of the duodenal diverticulum (5 observations). Dissertation . Munich 1927, OCLC 71872498 .
  • Hugo Karl Lill: About the duodenal diverticulum. Dissertation. Bielefeld 1939, DNB 57084262X .
  • Astrid Hehl: The clinical significance of the duodenal diverticulum. Dissertation. Saarbrücken 1996, DNB 948957859 .

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