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Conservative Management of Perforated Duodenal Diverticulum: A Case Report and Narrative Review
Tagleb S Mazahreh1, Mohammed W Afaneh1, Anas Husein1
1Department of General Surgery and Urology, Faculty of Medicine, Jordan University of Science and Technology, King Abdullah University Hospital (KAUH), Irbid, 22110, Jordan.
Abstract:
Duodenal diverticular disease is a common finding in the general population and most individuals, in fact, remain asymptomatic. However, duodenal diverticular perforation is an occasional unfortunate endpoint that carries significant morbidity, and mortality rates and requires a particular attention and a wise judgement whether to liberally interfere surgically or to stay more conservative.In this writing, we describe a case of a 45-year-old male with a perforated duodenal diverticulum that presented in a stable general condition and was successfully managed conservatively, sparing the patient a particularly morbid surgical intervention. Perforated duodenal diverticula, though rare, can be managed conservatively in stable patients without signs of sepsis or generalized peritonitis. Conservative treatment, including intravenous antibiotics, bowel rest, and nasogastric suction, can be effective and avoid the morbidity associated with surgery. In our case, conservative management led to significant improvement, underscoring the importance of individualized treatment plans and close monitoring to decide on the necessity of surgical intervention.Conservative management of perforated duodenal diverticula should be considered in selected patients who fulfill the general settled criteria. Nevertheless, an individualized approach is recommended and escalating up the invasiveness of interventions may seem vital at any time during treatment.
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