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Laparoscopic diverticulectomy for a perforated duodenal diverticulum: a case report
Han Hong Lee1, Ji Young Hong, Soon Nam Oh
1Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|September 30, 2010
Summary
This study presents the first laparoscopic treatment for a perforated duodenal diverticulum. A minimally invasive diverticulectomy successfully resolved severe abdominal pain in a patient diagnosed via computed tomography.
Area of Science:
- Gastroenterology
- Surgical Innovation
Background:
- Duodenal diverticula are uncommon, and perforation presents a rare surgical emergency.
- Computed tomography (CT) is crucial for diagnosing complex gastrointestinal pathologies like perforated diverticula.
Observation:
- A 61-year-old female presented with acute abdominal pain, nausea, and vomiting.
- CT revealed a perforated duodenal diverticulum with air and food material in the posterior second duodenal portion.
- Emergency laparoscopic exploration identified a ~4-cm perforated diverticulum with reactive fluid.
Findings:
- Laparoscopic diverticulectomy was successfully performed using ultrasonic shears.
- The duodenal defect was closed with two layers of intracorporeal hand-sewn sutures.
- The patient recovered well and was discharged on postoperative day 10 without complications.
Implications:
- This case demonstrates the feasibility and safety of laparoscopic management for perforated duodenal diverticula.
- Minimally invasive surgery offers a viable alternative to open procedures for this rare condition.
- Highlights the importance of advanced imaging and laparoscopic techniques in managing acute abdominal emergencies.
