Intramural duodenal diverticulum mimicking a periampullary neoplasm.
A 34-year-old woman presented with epigastric pain, nausea, and dyspepsia. Contrast-enhanced computerized tomography revealed a small mass in the duodenal wall mimicking a periampullary neoplasm and, at endoscopic examination, a periampullary submucosal tumor was suspected. The diagnosis of intramural duodenal diverticulum (IDD) was made by an x-ray barium meal that showed a finger-like sac filled with barium, the so-called "windsock sign." IDD is a rare congenital abnormality caused by an anomalous process of recanalization of the primitive foregut. The intermittent filling and emptying of the IDD is responsible for epigastric pain, nausea, and vomiting. When IDD is symptomatic, surgical or endoscopic treatment is recommended.
Clemente
Gennaro
G
Department of Surgery, A. Gemelli Medical School, Largo Gemelli, 8-00168 Rome, Italy. gclemente@rm.unicatt.it
Sarno
Gerardo
G
Giordano
Marco
M
De Rose
Agostino M
AM
Nuzzo
Gennaro
G
D000328:Adult; D014670:Ampulla of Vater / Q000000981:diagnostic imaging; D001466:Barium Sulfate; D003287:Contrast Media; D003937:Diagnosis, Differential; D004240:Diverticulum / Q000000981:diagnostic imaging*; D004378:Duodenal Diseases / Q000000981:diagnostic imaging*; D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging; D004386:Duodenum / Q000002:abnormalities / Q000000981:diagnostic imaging*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D001466:Barium Sulfate