Intraluminal duodenal diverticulumの1例

Intraluminal Duodenal Diverticulum, Report of a Case

　Intraluminal duodenal diverticulum（以下，IDDと略す）は十二指腸第2部に内腔に突出する嚢状，または吹き流し状の憩室を有するまれな消化管奇形で，そのX線像は特徴的である．今回われわれはIDDの1例を経験したので，これを報告し，自験例も含めて本邦16例の検討を行った．

　A 45-year-old man was admitted to our hospital with a complaint of abdominal fullness which had lasted two months. Hypotonic duodenography gave a pear-shaped sac surrounded by a thin radiolucent wall on the middle of the second part of the duodenum. Through the endoscopy, an opening of the sac adjacent to the papilla of Vater was observed. The intraluminal duodenal diverticulum (IDD) was diagnosed. The patient underwent lapalotomy for the resection of the diverticulum. The postoperative course was uneventful.

　IDD is an intestinal anomaly of low incidence. This case report together with a review of fifteen others reported in Japan was studied. Out of the sixteen cases reported, ten were male and six were female. The patient's age ranged from seven to sixty-one years old, with the mean of thirty four. The most common symptom due to IDD was epigastralgia which was observed in nine cases (59％).　Upper abdominal fullness was the complaint in three (19％). Some patients also complained of nausea and vomiting. Three (19％) who were diagnosed by mass screening study of upper gastrointestinal series showed no symptom. Other pathological conditions co-existed with IDD, such as malrotation of the intestine, annular pancreas, acute pancreatitis, cholelithiasis, and peptic ulcer, were observed in seven (44％). All the lesions of IDD were found on the second part of the duodenum. Surgical treatment was performed in eleven (85％), including two who had the endoscopic resection. Two were treated conservatively. The way of treatment was not described in three. No death during operation was reported.