십이지장 폐색을 동반한 거대 십이지장 내강 내 게실 1례

Abstract

Intramural duodenal diverticulum is a rare congenital anomaly. A 31-year-old woman presented for abdomianl pain and vomiting. She had several episodes of acute pancreatitis in the past several years. On physical examination, although she complained epigastric area abdominal pain, but there was no tenderness. Laboratory investigations showed that highly increased serum level of amylase and lipase (10540 U/L and 12620 U/L, respectively). Enhanced abdominal computed tomography demonstrated an blind-ended tube with thick wall and hydroaeric content, localized within the proximal jejunum and distension of 3-4th portion of duodenum. Upper gastrointestinal series showed complete duodenal obstruction on 3rd portion. The patient underwent surgery and 10 cm sized intramural duodenal diverticulum was found at junction of 3rd and 4th duodenum and completely obstructed duodenal lumen. It was resected. The patient recovered quickly and remained healthy after a one-year follow-up. When intramural duodenal diverticulum was occurs at distal duodenum, surgical resection is necessary.