Intraluminal duodenal diverticulum

A 76-year-old man with an iron deficiency anemia during the previous 4 years and recent melena was presented. Gastroscopy showed a sessile polypoid lesion in the area of the papilla of Vater and histology was normal. Barium swallow follow-through and CT scan revealed a round intraluminal filling defect. ERCP demonstrated extrinsic compression of both ducts. Emergency laparotomy was performed because of upper GI bleeding and because attempts at endoscopic haemostasis of the oozing polypoid mass were unsuccessful. A soft compressible polypoid mass was found, which on palpation excreted a viscous milky liquid through a tiny opening. Histology showed normal duodenal mucosa bilaterally, a diagnostic finding of intraluminal duodenal diverticulum. The atypical age of presentation as well as gastroscopic and roentgenographic findings of this rare entity are illustrated.