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Lee, Moon, Park, Lim, Lee, and Ko: Perforated Duodenal Diverticulum Caused by Bezoar: A Case Report
Abdominal Radiology

Journal of the Korean Society of Radiology 2013; 69(5): 373-376.

Published online: 8 November 2013

DOI: https://doi.org/10.3348/jksr.2013.69.5.373

Perforated Duodenal Diverticulum Caused by Bezoar: A Case Report

Jung Eun Lee, MD, Sung Kyoung Moon, MD, Seong Jin Park, MD, Joo Won Lim, MD, Dong Ho Lee, MD, Young Tae Ko, MD

Department of Radiology, College of Medicine, Kyung Hee University, Seoul, Korea.

Corresponding author: Sung Kyoung Moon, MD. Department of Radiology, College of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-702, Korea. Tel. 82-2-958-8622, Fax. 82-2-968-0787, aquamsk@naver.com

Received 5 July 2013       Accepted 5 August 2013

Copyright © 2013 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Duodenal diverticulum is common, but its perforation is a rare complication. Duodenal diverticulum perforation requires prompt treatments because of its high mortality rate. However, an accurate diagnosis is difficult to make due to nonspecific symptoms and signs. It can be misdiagnosed as pancreatitis, cholecystitis, or peptic ulcer. Herein, we report a case of perforated duodenal diverticulum caused by bezoar in a 33-year-old woman whom was diagnosed by abdomen computed tomography and ultrasonography.

Keywords: Duodenal Diverticulum, Perforation, Bezoar, CT

Figures and Tables

Fig. 1
A 33-year-old woman with perforated duodenal diverticulum with epigastric pain.
A. On an axial CT image, an irregular fluid collection (asterisk) containing air-bubbles is shown at the posterior aspect of the pancreas uncinate process. It displaces the pancreas head (black arrow) and duodenum (white arrow) anteriorly.
B. An abdomen ultrasonography shows a hard material (white arrow) with posterior acoustic shadow in the duodenal diverticulum. The pancreas parenchyma (asterisk) shows normal appearance.
C. A coronal CT image shows the discontinuity of the superior wall of duodenal diverticulum (white arrow) and communication (black arrows) with complicated fluid collection (asterisk) around the pancreas head.
Note.-D = duodenum
jksr-69-373-g001
Fig. 2
The follow-up abdomen CT and endoscopy.
A. An axial CT image shows the decrease in size of duodenal diverticulum (white arrow). There is no more fluid collection near the pancreas head and uncinate process (black arrow = duodenum).
B. An endoscopy shows the opening of the duodenal diverticulum at the periampullary region.
jksr-69-373-g002

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