Clinical significance of duodenal diverticula.

Duodenal diverticula are found in up to 22 percent of the population. According to the literature, less than 10 percent of duodenal diverticula will cause symptoms, and about 1 percent will require definite treatment. There is no indication for treatment of asymptomatic patients with duodenal diverticula. A trial of conservative treatment is justified if the symptomatic patient is in stable condition. If symptoms persist or serious complications are present and other pathology of the abdomen that might be responsible is ruled out, definitive treatment is necessary. For intraluminal duodenal diverticula an elective endoscopic approach is possible. Our approach for extraluminal duodenal diverticula is discussed herein. The clinical presentations of 50 patients from 1986 to 1992 are summarized. In a surprisingly high proportion (12 percent), the symptoms could be clearly related to the duodenal diverticula. Eight percent were treated surgically, and postoperative mortality rates zero. In the literature, postoperative mortality rates even for elective surgery are 8 to 12 percent and reach 20 percent for emergency operations.