Giant duodenal diverticulum masquerading as a sealed perforation

Area of Science:

• Gastroenterology
• Abdominal Imaging
• Surgical Case Reports

Background:

• Giant duodenal diverticula are rare outpouchings of the duodenum, often asymptomatic.
• They can present with complications such as diverticulitis or biliary obstruction.
• Accurate diagnosis is crucial for appropriate management.

Observation:

• A patient presented with symptoms initially misdiagnosed as duodenal perforation on CT scan.
• Further imaging with ultrasound and fluoroscopy was required for correct diagnosis.
• The case underscores the potential for misinterpretation of imaging findings.

Findings:

• The patient was ultimately diagnosed with acute cholecystitis, with the giant duodenal diverticulum being an incidental finding.
• Computed tomography (CT) alone was insufficient for definitive diagnosis, leading to initial misdiagnosis.
• Multimodality imaging proved essential for clarifying the diagnosis.

Implications:

• This case emphasizes the importance of considering giant duodenal diverticula in the differential diagnosis of acute abdominal conditions.
• It highlights the limitations of relying solely on CT scans for complex abdominal presentations.
• Multimodality imaging approaches are vital for accurate diagnosis and management of rare gastrointestinal conditions.