Economides N G, McBurney R P, Hamilton F H
Ann Surg. 1977 Feb;185(2):147-52. doi: 10.1097/00000658-197702000-00003.
Four patients with intraluminal diverticulum of the duodenum are presented and compared with those reported previously. This lesion is a rare congenital disorder that usually becomes symptomatic in adult life. It is located in the second portion of the duodenum within the lumen, extending distally. It has the appearance of a "thumb of a glove" and it is lined by mucosa on both surfaces. It develops betweeen the fourth and eighth week of the embryo's life, but it increases in size during adult life. It usually presents with typical or atypical symptoms of peptic ulcer disease, but sometimes manifestations such as gastrointestinal bleeding, duodenal obstructions or pancreatitis may predominate and may be severe and life-threatening. The diagnosis is best made with hypotonic duodenography, which demonstrates the lesion as a barium coated pouch within the air filled duodenal lumen. The treatment of choice is duodenotomy and excision of the lesion. Proper identification of the papilla of the ampulla of Vater is important since this structure is often adjacent to the diverticulum. No recurrences have been noted in the three patients operated upon.
本文报告了4例十二指肠腔内憩室患者，并与先前报道的病例进行了比较。这种病变是一种罕见的先天性疾病，通常在成年期出现症状。它位于十二指肠第二段的腔内，向远端延伸。其外观呈“手套拇指”状，两面均衬有黏膜。它在胚胎生命的第4至8周之间形成，但在成年期会增大。它通常表现为消化性溃疡疾病的典型或非典型症状，但有时诸如胃肠道出血、十二指肠梗阻或胰腺炎等表现可能更为突出，且可能严重并危及生命。最佳诊断方法是低张十二指肠造影，它可将病变显示为充满气体的十二指肠腔内的钡剂涂布袋。首选的治疗方法是十二指肠切开术并切除病变。正确识别十二指肠乳头很重要，因为该结构常与憩室相邻。接受手术的3例患者均未出现复发。
