Ohmori Masayasu, Harada Ryo, Hashimoto Kenji, Inoo Shoko, Himei Hitomi, Toshimori Junichi, Asano Motoi, Maeshima Reijiro, Inoue Masafumi, Kobashi Haruhiko
Department of Gastroenterology, Japanese Red Cross Okayama Hospital.
Department of Hepatology, Japanese Red Cross Okayama Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2017;114(5):871-880. doi: 10.11405/nisshoshi.114.871.
We encountered two cases of perforated duodenal diverticulum successfully treated with conservative therapy. The first case involved a 72-year-old man who presented with abdominal pain and fever. An abdominal computed tomography revealed pneumoretroperitoneum. The second case involved a 90-year-old woman who presented with abdominal pain, vomiting, and fever. An abdominal computed tomography also revealed pneumoretroperitoneum and fluid collection. In both the cases, we initiated conservative therapy with parenteral nutrition and intravenous antibiotic therapy because the patients' general condition was good and the pneumoretroperitoneum was localized. Both patients were cured without serious complications and were discharged from the hospital 14 days after admission. Conservative treatment may be useful in the patients with early stage of perforated duodenal diverticulum and a good general condition without impending sepsis. However, in case of disease aggravation, careful observation and preparation for immediate surgical drainage are desired.
