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January 1959

Duodenal Diverticulitis Presenting as Acute Surgical Abdomen: Case of Nonperforating Inflammatory Disease of Giant Duodenal Diverticulum with Suspected Peritonitis and Partial Intestinal Obstruction

Author Affiliations

U. S. A. F.; Philadelphia
Chief Medical Resident (Dr. Bendersky); Chief Surgical Resident (Captain Kownacki); Intern (Dr. Shane), Hahnemann Medical College and Hospital.

AMA Arch Surg. 1959;78(1):169-172. doi:10.1001/archsurg.1959.04320010171027

Despite the prevalence of primary duodenal diverticula, it is uncommon for these diverticula to be symptomatic. More than 5% of the population over the age of 55 have been estimated to have duodenal diverticula; as many as 1%-5% of this group have required surgery. In attempts at surgical alleviation of symptoms attributed to duodenal diverticula, disappointing results have often occurred. Furthmore, the dangers of surgery in this area are influenced by the following factors: (1) the close proximity of the duodenal diverticulum to the common bile duct and pancreatic duct: (2) the high incidence of multiple diverticula (10%-15%); (3) the occasional location of the diverticulum within the substance of the pancreas, and (4) the high incidence of duodenal fistula and the occasional death from postoperative pancreatitis.

Patterson and Blumberg reviewed 34 cases of duodenal diverticulum in which surgery was performed and found 3 operative deaths, an over-all operative mortality of

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