Intraluminal duodenal diverticula（IDD）の興味ある1例

Duodenal Diverticula: Report of a Case Investigated by Fiberoptic Endoscopy

　Intraluminal duodenal diverticula（以下IDD）の報告例は近年その数を増し，われわれの調べた範囲では現在までに欧米で49例が報告されている．本邦においても1970年木原ら¹⁾が初めて報告して以来，成人例2例²⁾，小児1例³⁾が報告されている．今回われわれはIDDに輪状膵，急性膵炎を合併した1例を経験したので報告する．

　Intraluminal duodenal diverticulum was once considered a very rare disease, but an increasing number of cases has recently been reported. In Japan, three cases have been reported so far since the first case was described by Kihara et al. in 1970. This is a case report of a 42 years old patient who was referred to our clinic because of repeated episodes of abdominal pain and marked hyperamylasemia. Upper GI series revealed a saccular radiolucent line in the descending part of the duodenum, which proved to be intraluminal duodenal diverticulum as confirmed by hypotonic duodenography and endoscopic examination. Endoscopic retrograde cholangio-pancreatography revealed normal biliary tract and mild irregularity of the pancreatic duct. Our preoperative diagnosis was intraluminal duodenal diverticulum and secondary acute relapsing pancreatitis.

　Laparotomy revealed intraluminal duodenal diverticulum accompanied by another congenital anomaly: complete annular pancreas. Resection of the diverticulum was performed but no surgical procedure was attempted on annular pancreas because no stenotic lesions were found in the duodenum and biliary tract. Histological examination of the diverticulum showed a thin septum covered by normal duodenal epithelium.

　Postoperative course of the patient has been un-eventful for nine months.