[Relationship between duodenal diverticuli, gallstones and duodenal and pancreaticobiliary disorders]

To determine the relationship between duodenal diverticula and the prevalence of bile duct stones, and between duodenal diverticula and pancreatic pathology and/or duodenal inflammation.

Retrospective descriptive study.

Department of Internal medicine, Division of Gastroenterology/Hepatology, University Hospital Maastricht.

The medical records were reviewed of 273 consecutive patients in whom an endoscopic retrograde cholangiopancreatography (ERCP) had been performed for the first time during the period 1991-1992. Clinical data such as previous history of cholecystectomy and ERCP findings such as presence of a duodenal diverticulum, its location (juxtapapillary or circumpapilary), and possible concomitant pancreaticobiliary disorders and/or duodenal inflammation were evaluated.

Duodenal diverticula were present in 49 out of 273 patients (18%(: 30 patients with a juxtapapillary, 18 patients with a circumpapillary duodenal diverticulum and one patient with both types. A history of cholecystectomy was not reported more frequently in patients with a diverticulum than in those without. At the time of ERCP investigation, gallbladder stones were not diagnosed more frequently in diverticulum patients. A significantly higher prevalence of common bile duct stones was found in diverticulum patients than in those without (53% versus 22%, p = 0.001). Pancreatic pathology was not related to the presence of duodenal diverticula (p = 0.441). Furthermore. duodenitis and duodenal ulcers were significantly more prevalent in diverticulum patients than in those without (18% versus 7% for duodenitis, p = -0.049; 14% versus 2% for duodenal ulcers, p = 0.001).

Duodenal diverticula were not only associated with common bile duct stones, but were also related to duodenitis and duodenal ulcers. Pancreatic pathology appeared not to be related to duodenal diverticula.