Toyoshima Kai, Takishin Yunosuke, Toda Kiko, Nakajima Katsuma, Otuka Yutaro, Yokoyama Daisuke, Muranaka Tetsuhito, Kunieda Yasuyuki
Department of Internal Medicine Wakkanai City Hospital Hokkaido Japan.
DEN Open. 2024 Dec 15;5(1):e70044. doi: 10.1002/deo2.70044. eCollection 2025 Apr.
Small-bowel diverticulosis is relatively common, but there is no set treatment strategy for duodenal diverticulitis with stone impaction. A woman aged in her 70s presented with a chief complaint of abdominal pain, and she had been reconstructed by the Roux-en-Y method after total gastrectomy. We performed an enhanced computed tomography which revealed edematous wall thickening of the duodenum. We diagnosed her with duodenal diverticulitis and treated them with antibiotics but her disease was not cured, we therefore attempted endoscopic stone removal as a nonoperative treatment. After stone removal with a nonoperative procedure, when we contrasted the duodenal papillary diverticulum, it was found to form a fistula on the other side, and the successful treatment made her discharged on the 17th day. The duodenal diverticulitis with calculus is extremely rare, and there is no report to treat it using double-balloon endoscopy, therefore we report this case with a literature review.
小肠憩室病相对常见，但对于伴有结石嵌顿的十二指肠憩室炎尚无既定的治疗策略。一名70多岁的女性以腹痛为主诉就诊，她在全胃切除术后接受了Roux-en-Y重建术。我们进行了增强计算机断层扫描，结果显示十二指肠壁水肿增厚。我们诊断她患有十二指肠憩室炎，并使用抗生素进行治疗，但病情未治愈，因此我们尝试采用内镜取石作为非手术治疗方法。在通过非手术方法取出结石后，当我们对十二指肠乳头憩室进行造影时，发现其另一侧形成了瘘管，成功的治疗使她在第17天出院。伴有结石的十二指肠憩室炎极为罕见，且尚无使用双气囊内镜治疗的报道，因此我们报告此病例并进行文献综述。
