Complications of duodenal diverticulum

Q) True statement regarding complications of duodenal diverticulum is

a) Perforation is the commonest complication

b) Obstruction is caused by extra luminal duodenal diverticulum

c) Bleeding is the most common complication of duodenal diverticulum.

d) Diverticulitis is common and easily diagnosed.

Answer

c

Complications of duodenal diverticulum are rare with a reported incidence of 5-10% in those with duodenal  diverticulum. Operative intervention is required in about 1% cases

Perforation is the rarest but the most severe complication of duodenum diverticulum. The most common cause of perforated duodenal diverticulum is diverticulitis. They perforate in the retroperitoneum, adding to diagnostic uncertainty. Ct Scans are most diagnostic to help in this diagnosis.

Obstruction is commonly caused by intraluminal  duodenal diverticulum. It can also become obstructed by gall stones or undigested foreign particles.

Bleeding is the commonest complication of duodenal diverticulum and present as haematemesis or melena. Diagnosis and treatment is by endoscopy.

Duodenal diverticulitis is uncommonly diagnosed because of its site and diagnostic confusion with cholecystitis, pancreatitis and other upper GI causes.