[Preoperative diagnosis of a subacute perforation of a duodenal diverticulum]

Duodenal diverticula are very rarely complicated by perforation (less than 100 cases published) and it is unusual to diagnose the lesion prior to operation. This was possible, however, in a 71 year old patient admitted with a picture of cholecystopancreatitis explored by CT scan imaging and barium meal examination. Study of relevant documented data showed that apart from the progressive character, characterized by duodenocolic fistula, the diagnosis can be made in acute or subacute manifestations: previous knowledge of a diverticulum, air bubbles in paraduodenal region on straight abdominal image and urgent examination of transit using water soluble contrast medium.