Duodenal diverticulum
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 .
Web links
- Detailed review of ERCP and duodenal diverticulum
- T. Heuer, W. Frasch u. a .: Endoscopic division of an intraluminal duodenal diverticulum in adults due to upper abdominal discomfort. In: Journal of Gastroenterology. 42, 2004, pp. 1377-1379, doi: 10.1055 / s-2004-813539 .
- 2 endoscopic images of duodenal diverticulum
- L. Zukschwerdt: Duodenal diverticulum and gastric ulcer. In: Clinical weekly. 8, 1929, p. 1171, doi : 10.1007 / BF01737380 .
- D. Ladurner, E. Bodner, R. Thoma: The intramural duodenal diverticulum, a topographical variety of the intraluminal duodenal diverticulum. In: Langenbeck's archive for surgery. 344, 1977, p. 219, doi : 10.1007 / BF01254076 .