Presentation
Abdominal pain and vomiting.
Patient Data
An outpouching noticed from the superior margin of the third part of the duodenum measures about 36*40 mm, contains fluid and gas. It is of thinner wall than adjacent normal duodenal wall. No surrounding fat stranding is noted. Mesentery at mid abdomen appears misty within which multiple small soft tissue components suggesting mesenteric lymph nodes, and this represents mesenteric panniculitis.
Case Discussion
The patient was referred for contrast-infused CT of the abdomen due to a soft tissue lesion noticed at the gallbladder on a previous US scan which also revealed signs of cholecystitis, which can explain the presenting symptoms of abdominal pain and vomiting, CT scan was done and revealed no gallbladder lesion, and the lesion which was initially discovered on US, was confirmed - by another scan - to be thick sludge that changes position with patient mobility. The duodenal diverticulum was found incidentally.
Duodenal diverticula can be primary or secondary. Primary duodenal diverticula commonly originate from second, third or fourth part of duodenum and rarely form first part of duodenum where secondary diverticular commonly originate. Like diverticula of other parts of the gastrointestinal tract, duodenal diverticula can be complicated by inflammation, infection, and hemorrhage.