General and Emergency Surgical Clinic. S. Maria Hospital, University of Perugia, Terni, Italy.
General and Emergency Surgical Clinic. S. Maria Hospital, University of Perugia, Terni, Italy ; General and Emergency Surgical Clinic. S. Maria Hospital, University of Perugia, Via Tristano di Joannuccio 1, Terni, Italy.
World J Emerg Surg. 2013 Jul 16;8:26. doi: 10.1186/1749-7922-8-26. eCollection 2013.
The duodenum is the second seat of onset of diverticula after the colon. Duodenal diverticulosis is usually asymptomatic, but duodenal perforation with abscess may occur.
Woman, 83 years old, emergency hospitalised for generalized abdominal pain. On the abdominal tomography in the third portion of the duodenum a herniation and a concomitant full-thickness breach of the visceral wall was detected. The patient underwent emergency surgery. A surgical toilette of abscess was performed passing through the perforated diverticula and the Petzer's tube drainage was placed in the duodenal lumen; the duodenostomic Petzer was endoscopically removed 4 months after the surgery.
A review of medical literature was performed and our treatment has never been described.
For the treatment of perforated duodenal diverticula a sequential two-stage non resective approach is safe and feasible in selected cases.
十二指肠是继结肠之后憩室起始的第二部位。十二指肠憩室通常无症状，但可能发生十二指肠穿孔伴脓肿。
女性，83 岁，因全腹痛急诊入院。在十二指肠第三段的腹部 CT 中发现疝出和同时发生的全层内脏壁破裂。患者接受了紧急手术。通过穿孔憩室进行脓肿的外科清创，并在十二指肠腔内放置 Petzer 管引流；术后 4 个月经内镜取出十二指肠吻合 Petzer。
对医学文献进行了回顾，我们的治疗方法从未被描述过。
对于穿孔性十二指肠憩室，在选择的病例中，序贯两阶段非切除术方法是安全可行的。
