[Diverticula of the duodenal orifice]

The authors present a synthesis of data from the literature, as well as of particularities that have confronted them in connection with 16 observations of mucous diverticuli of duodenal windows (of which 7 were interposed and 9 were juxtaposed). After a definition of the window diverticuli, of their types and of their repercussions, clinical data are commented upon, the possibilities offered by paraclinical investigations and by the intra-operatory methods, as well as the different therapeutical procedures. In relation with the clinical manifestation the diverticuli may be latent (or asymptomatic), they may be accompanied by direct signs of stasis and inflammation, or with biliary and pancreatic signs--an expression of the unfavourable influence exerted by the diverticuli on the biliary and pancreatic transits. The choice of the therapeutical procedure depends on the type of the diverticuli, the modality of the clinical expression and the bilio-pancreatic effects determined by them. Direct interventions can be performed on juxtaposed diverticuli, although this implies considerable risk, but indirect interventions are to be preffered, in which, in relation with the particularities of the case, the biliary transit is derivated or the duodenum is excluded from the digestive pathways.