Kaohsiung Journal of Medical Sciences
Volume 24, Issue 8 , Pages 425-429, August 2008

Successful Management of Perforated Duodenal Diverticulitis With Intra-abdominal Drainage and Feeding Jejunostomy: A Case Report and Literature Review

  • Chin-Fan Chen

      Affiliations

    • Department of Surgery, Kaohsiung, Taiwan
    • ,
  • Deng-Chyang Wu

      Affiliations

    • Department of Internal Medicine, Kaohsiung, Taiwan
    • Department of Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Chao-Wen Chen

      Affiliations

    • Department of Emergency Medicine, Kaohsiung, Taiwan
    • ,
  • Jan-Sing Hsieh

      Affiliations

    • Department of Surgery, Kaohsiung, Taiwan
    • Department of Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Chiao-Yun Chen

      Affiliations

    • Department of Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Jaw-Yuan Wang

      Affiliations

    • Department of Surgery, Kaohsiung, Taiwan
    • Department of Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Professor Jaw-Yuan Wang, Department of Surgery, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan

Received 1 August 2007; accepted 15 October 2007.

Article Outline

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.

Key Words:  duodenal diverticulum , feeding jejunostomy , intra-abdominal drainage , perforation

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PII: S1607-551X(08)70167-0

doi:10.1016/S1607-551X(08)70167-0

Kaohsiung Journal of Medical Sciences
Volume 24, Issue 8 , Pages 425-429, August 2008

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