A Rare Cause of Acute Upper Abdominal Pain: Diverticulitis of the 3rd Portion of the Duodenum |
Yong Woo Ahn, Kang Nyeong Lee, Eun Young Doo, Ki Deok Yoo, Young Taek Kim, Kang Won Lee, Oh Young Lee, Byung Chul Yoon |
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. drkangmd@naver.com |
급성 상복부 통증의 드문 원인: 십이지장 3부의 게실염 |
안용우, 이강녕, 두은영, 유기덕, 김영택, 이강원, 이오영, 윤병철 |
한양대학교 의과대학 내과학교실 |
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Abstract |
Duodenal diverticulitis is a rare cause of upper abdominal pain and is usually not considered when evaluating patients with acute upper abdominal pain. Furthermore, the duodenum is located near the pancreas and bile duct, and duodenal diverticulitis can be misdiagnosed as acute pancreatitis, cholangitis, cholecystitis, or other pancreatobiliary disorders such as pancreatic cystic neoplasms. Recently, we experienced a rare case of duodenal diverticulitis in the 3rd portion of the duodenum. The patient presented with deep seated upper abdominal pain aggravated by supine posture and relieved by sitting up. The patient was initially diagnosed with acute pancreatitis. However, serum levels of pancreatic enzymes were normal and abdominal CT scan revealed diverticulitis in the 3rd portion of the duodenum. The patient was successfully managed conservatively. Delayed diagnosis of duodenal diverticulitis can result in substantial morbidity and mortality if duodenal perforation occurs and should be considered as a possible cause of upper abdominal pain. |
Key Words:
Abdominal pain; Duodenal diverticulum; Diverticulitis; Pancreatitis |
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