Successful management of perforated duodenal diverticulitis with intra-abdominal drainage and feeding jejunostomy: a case report and literature review.

Chin-Fan Chen, Deng-Chyang Wu, Chao-Wen Chen, Jan-Sing Hsieh, Chiao-Yun Chen, Jaw-Yuan Wang

Journal: The Kaohsiung journal of medical sciences 2009;24(8):425-9

PMID: 18926957

Abstract

We report the clinical experience of one patient with perforated duodenal diverticulitis who was successfully treated by intra-abdominal drainage and feeding jejunostomy. A 53-year-old male patient visited our hospital due to acute onset of abdominal pain and distension. Physical examination revealed tenderness over the epigastric area and right-lower quadrant of the abdomen without obvious rebound tenderness or muscle guarding. Duodenal diverticulitis with a retroperitoneal abscess was identified by abdominal computed tomography scan. Surgical intervention was performed after the failure of conservative treatment. The operative findings were compatible with perforated duodenal diverticulitis, and intra-abdominal drainage of retroperitoneal abscess with simultaneous feeding jejunostomy was undertaken. The patient was doing well at the 4-month postoperative follow-up visit. We suggest the use of a conservative operative method, as opposed to conventional diverticulectomy and duodenorrhaphy, as an alternative approach for the management of this disorder, especially when conservative treatment has failed.

Address: Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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