DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150848

A patient presenting with recurrent post-prandial abdominal discomfort and vomiting

Ashis Kumar Saha, Payodhi Dhar, Payodhi Dhar, Abhiparna Roy, Abhiparna Roy, Soumesh Roy, Soumesh Roy

Abstract


Duodenal diverticulum is the second most common diverticulum of gastrointestinal tract. Among duodenal diverticulum, incidence of intramural duodenal diverticulum is 100 as per report till date. It is usually asymptomatic, but in middle or adult age, it may present with postprandial abdominal discomfort, often complicates in the form of bleeding, perforation or rarely neoplasm. So, this congenital duodenal deformity requires urgent definitive treatment. Here we presented a case presenting with postprandial abdominal discomfort with occasional vomiting. He was advised upper gastrointestinal endoscopy. It showed evidence of duodenal septa at the junction of 1st and 2nd part. Scope was negotiated through one channel. He was advised barium meal of stomach, duodenum and follow through, which ultimate demonstrated presence of a rare abnormality, duodenal intramural diverticulum, which if not treated, can produce severe complication in future.


Keywords


Upper gastro duodenal endoscopy, Barium meal of stomach duodenum, Postprandial abdominal discomfort, Intramural duodenal diverticulum

Full Text:

PDF

References


Pimparkar BD. Diverticulosis of small intestine In: Bockus Henry L, (Ed). Gastroenterology. 3rd (Ed). Philadelphia: WB Saunders Co 1976;437-58.

Knoefel WT, Rattner DW. Duodenal diverticula and duodenal tumors In: Morris PJ, Malt RA (Ed). Oxford of Surgery. New York: Oxford University Press 1994;1:943-946.

Cheshire NJ, Glezer G. Diverticula, Volvulus, superior mesenteruic artery syndrome and foreign bodies. In: Zinner MJ, Schwartz SI, Ellis H, (Ed). Maingoats Abdominal operation 10th (Ed). London: Prentice Hall International Ince (UK) Limited 916-921.

Lobo N, Balfour TW, Iftikar SY, Rowlands BJ. Periampullary diverticula and pancreatico biliary disease. Br J Surg. 1999;86:588-97.

Harford WW. Diverticula of hypopharynx and esophagus, the stomach and small bowel. In: Feldman M, Scharschmidt BF, Sleisenger MH, (Ed). Sleisenger and Fordtran’s Gastroenterology and Liver Diseases. 6th (Ed). Philadelphia: WB Saunders Co. 1998;1:313-316.

Lane JE, Ajjan M, Sedghi S. GI bleeding from duodenal diverticula. Am J Gast. 2001:2799.

Yin wee, Chen HT, Huang SM, Lin HH, Chang TM. Clinical analysis and literature review of massive duodenal diverticular bleeding. World J Surg 2001;25:848-55.

Rioux L, Des Groseilliers S, Fortin M, Mutch do. Massive upper gastrointestinal bleeding originating from a fourth stage duodenal diverticulum: A case report and review of literature. Can J Surg. 1996;39:510-2.

Afridi SA, Fitchenbaum CJ, Taubin H. Review of duodenal diverticula. Am J Gastroenterology. 1991;86:935-8.