CLINICAL-SIGNIFICANCE OF DUODENAL DIVERTICULA

Duodenal diverticula are found in up to 22 percent of the population. According to the literature, less than 10 percent of duodenal divertic ula will cause symptoms, and about 1 percent will require definite tre atment. There is no indication for treatment of asymptomatic patients with duodenal diverticula. A trial of conservative treatment is justif ied if the symptomatic patient is in stable condition. If symptoms per sist or serious complications are present and other pathology of the a bdomen that might be responsible is ruled out, definitive treatment is necessary. For intraluminal duodenal diverticula an elective endoscop ic approach is possible. Our approach for extraluminal duodenal divert icula is discussed herein. The clinical presentations of 50 patients f rom 1986 to 1992 are summarized. In a surprisingly high proportion (12 percent), the symptoms could be clearly related to the duodenal diver ticula. Fight percent were treated surgically. and postoperative morta lity rate was zero. In the literature, postoperative mortality rates e ven for elective surgery are 8 to 12 percent and reach 20 percent for emergency operations.