DUODENAL DIVERTICULA AND ACUTE-PANCREATIT IS

The purpose of this study was to assess the role of duodenal diverticu la as an etiologic factor in acute pancreatitis. Methods and patients: We have reviewed the records of patients with diverticulum of the sec ond portion of the duodenum diagnosed by gastroduodenal radiology or e ndoscopy during the period 1991-1992 in our hospital. As a control gro up we studied patients without duodenal diverticulum. All subjects und erwent biliary-pancreatic ultrasonography. Thirty-eight patients had a duodenal diverticulum and gallstones 36 had a duodenal diverticulum b ut no gallstones; 21 had gallstones alone; and, finally, 42 patients w ere free of duodenal diverticulum and gallstones. Results: Patients wi th duodenal diverticula had a greater prevalence of gallstones than th ose without (51.3% VS 33.3%, p < 0.005). Of the thirty-eight patients with duodenal diverticula and gallstones 23.7% had acute pancreatitis. None of the 21 patients without duodenal diverticulum and with gallst ones had acute pancreatitis, p < 0.05, The median age of patients with duodenal diverticulum without gallstones was 64.25 years, range 3485, and the age of those with duodenal diverticulum and gallstones was 70 .4 years, range 37-87, p < 0.05. Conclusions: 1) Gallstones may cause acute pancreatitis in patients with D2 duodenal diverticula. 2) Patien ts with a D2 duodenal diverticulum frequently have gallstones. 3) The fact that the age of patients with duodenal diverticulum was lower tha n that of patients with both duodenal diverticulum and gallstones sugg ests that duodenal diverticula may play a role in the pathogenesis of gallstones