Fact-sheet: Duodenal diverticulum
Updated on 09/17/2021 at 12:16 PM
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Definition
Duodenal diverticulum -
Common: 10 to 20% of the population -
Asymptomatic -
Develops from D2 to D4: D2 30% > D3 30% > D4 10%
-2 types:
acquired: herniation of the mucosa and submucosa through areas of weakness in the muscularis, exoluminal development
congenital: rare, endoluminal development
Complications:
- duodenal diverticulitis with or without perforation +++
- iatrogenic perforation (ERCP ++)
- biliary complications: increased incidence of gallstone disease with large diverticula
- GI bleeding.
CT
Simple diverticulum -
Well-defined exoluminal outpouching communicating with the duodenum -
Upper GI contrast studies may demonstrate this communication -
Thin wall, no periduodenal fat abnormality when uncomplicated -
variable contents (air, air-fluid level, fluid, food)
NB: > 50% of duodenal diverticula are located within 2 cm of the papilla: this should be specified if ERCP is planned, for more careful cannulation
The papilla may be intradiverticular, juxtadiverticular, or occasionally located between 2 diverticula
Duodenal diverticulitis: same imaging features as other forms of diverticulitis
diverticular wall thickening
periduodenal fat stranding