Shapira O, Simon D, Pfeffermann R
Dept. of Surgery B, Kaplan Hospital, Rehovot.
Harefuah. 1990 Nov 1;119(9):267-9.
We describe a 77-year-old man with recurrent upper gastrointestinal tract bleeding and ascending biliary infection secondary to a duodenal diverticulum. Although such diverticula are relatively common, the great majority are asymptomatic and are only discovered incidentally. Only 1% manifest clinically, usually secondary to a variety of complications such as bleeding, perforation, ascending biliary infection or pancreatitis. Most often the diagnosis is made by exclusion, which accounts for the usual delay in starting treatment. When present, one must consider the possibility that the duodenal diverticulum may be responsible for the patient's symptoms. The preferred approach to a bleeding diverticulum is complete excision, while bypassing the diverticulum by Roux-en-Y duodenojejunostomy is the operation of choice for pancreaticobiliary complications.
我们描述了一名77岁男性，因十二指肠憩室继发反复上消化道出血和上行性胆道感染。尽管此类憩室相对常见，但绝大多数无症状，仅偶然被发现。只有1%会出现临床症状，通常继发于各种并发症，如出血、穿孔、上行性胆道感染或胰腺炎。大多数情况下，诊断是通过排除法做出的，这也是治疗开始通常延迟的原因。当出现症状时，必须考虑十二指肠憩室可能是患者症状的病因。对于出血性憩室，首选的方法是完整切除，而对于胰胆并发症，通过Roux-en-Y十二指肠空肠吻合术绕过憩室是首选的手术方式。
