Management of the intraluminal duodenal diverticulum: endoscopy or duodenotomy?

The intraluminal duodenal diverticulum is an uncommon congenital anomaly which is associated with obstructive symptoms. Treatment of the symptomatic intraluminal duodenal diverticulum can be undertaken either endoscopically with excision by snare cautery or with duodenotomy and excision of the diverticulum. An understanding of the embryologic and anatomic characteristics of the intraluminal duodenal diverticulum is essential in order to select the best treatment and avoid the pitfall of inadvertent pancreatic or bile duct injury.