Duodenal Diverticulum as the Cause of Unexplained Duodenal Stenosis

[摘要] A 65-year-old female patient presented for an evaluation of duodenal stenosis. She had a decades-long history of nausea and vomiting. Endoscopy revealed the cause to be short-segment duodenal stenosis with a subsequent submucosal soft mass that filled the duodenal lumen in an almost circular manner. Computed tomography showed an intraluminal sack-shaped mass in the descending part of the duodenum with a thin, smooth wall, which, like the surrounding duodenum, filled with oral contrast medium (“windsock” sign). Intraluminal duodenal diverticula are rare congenital lesions that mostly occur adjacent to the papilla of Vater and occasionally also exhibit biliopancreatic lesions. The windsock sign is characteristic and often provides the key to diagnosis. Due to the anatomically challenging position, potentially complication-prone surgical or endoscopic attempts at resection should be avoided where possible. In the case of the patient presented here, a symptom-based approach was chosen (prokinetic agents). At 4 months following diagnosis and treatment initiation, the patient rated her symptoms as tolerable.

[学科分类] 医学（综合）