Endoscopic rendez-vous after damage control surgery in treatment of retroperitoneal abscess from perforated duodenal diverticulum: a techinal note and literature review

• Published in: World journal of emergency surgery Vol. 8; no. 1; p. 26
• Main Authors: Barillaro, Ivan, Grassi, Veronica, De Sol, Angelo, Renzi, Claudio, Cochetti, Giovanni, Barillaro, Francesco, Corsi, Alessia, Cacurri, Alban, Petrina, Adolfo, Cagini, Lucio, Boselli, Carlo, Cirocchi, Roberto, Noya, Giuseppe
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16-07-2013; BioMed Central
• Subjects: Case studies; Complications and side effects; Diverticulum; Endoscopy; Review; Italy; Duodenum; Complications; Diverticula; Perforation; Surgical treatment
• ISSN: 1749-7922; 1749-7922
• DOI: 10.1186/1749-7922-8-26

The duodenum is the second seat of onset of diverticula after the colon. Duodenal diverticulosis is usually asymptomatic, but duodenal perforation with abscess may occur.
Woman, 83 years old, emergency hospitalised for generalized abdominal pain. On the abdominal tomography in the third portion of the duodenum a herniation and a concomitant full-thickness breach of the visceral wall was detected. The patient underwent emergency surgery. A surgical toilette of abscess was performed passing through the perforated diverticula and the Petzer's tube drainage was placed in the duodenal lumen; the duodenostomic Petzer was endoscopically removed 4 months after the surgery.
A review of medical literature was performed and our treatment has never been described.
For the treatment of perforated duodenal diverticula a sequential two-stage non resective approach is safe and feasible in selected cases.