MAJOR COMPLICATIONS OF SMALL BOWEL DIVERTICULA
MAJOR COMPLICATIONS OF SMALL BOWEL DIVERTICULA
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DOI：
10.1097/00000658-197908000-00011
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发表时间：
1979-01-01
影响因子：
9
通讯作者：
DONALD, JW
中科院分区：
文献类型：
--
作者：
DONALD, JW
Complications of diverticula of the duodenum, jejunum and ileum, exclusive of Meckel''s diverticula, are extremely rare but can produce major diagnostic and therapeutic problems. Major reported complications include hemorrhage, perforation, biliary and pancreatic obstruction, and inflammation with intestinal obstruction. The mortality of complicated duodenal diverticula is reported at 33-48%. Experience with some of these complications is reported. This experience with a review of other reported cases have led to the following recommendations for surgical treatment. For massively bleeding duodenal everticulum, precise localization of the bleeding point by endoscopy and/or arteriography is highly desirable and excision or partial excision of the diverticulum with suture ligation of the bleeding point is necessary. With perforated duodenal diverticulum, excision or partial excision, secure closure and drainage are necessary. If peri-Vaterian, a probe should be passed through the ampulla of Vater via the common duct. Unless an entirely satisfactory closure is achieved, complete diversion of the enteric stream from the duodenum by vagotomy, antrectomy with closure of duodenal stump, and Billroth II anastomosis is recommended. For choledochal obstruction due to duodenal diverticulum, choledocho-duodenostomy is recommended. For perforation, bleeding, or obstruction due to jejunal or ileal diverticulum, in rare cases, local excision of the diverticulum is feasible. Usually, resection of the involved segment with primary anastomosis is indicated.
