Double-balloon endoscopy for duodenal diverticulitis with calculus after intestinal reconstruction: A case report

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY DEN open Pub Date : 2024-12-15 DOI:10.1002/deo2.70044
Kai Toyoshima, Yunosuke Takishin, Kiko Toda, Katsuma Nakajima, Yutaro Otuka, Daisuke Yokoyama, Tetsuhito Muranaka, Yasuyuki Kunieda
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Abstract

Small-bowel diverticulosis is relatively common, but there is no set treatment strategy for duodenal diverticulitis with stone impaction. A woman aged in her 70s presented with a chief complaint of abdominal pain, and she had been reconstructed by the Roux-en-Y method after total gastrectomy. We performed an enhanced computed tomography which revealed edematous wall thickening of the duodenum. We diagnosed her with duodenal diverticulitis and treated them with antibiotics but her disease was not cured, we therefore attempted endoscopic stone removal as a nonoperative treatment. After stone removal with a nonoperative procedure, when we contrasted the duodenal papillary diverticulum, it was found to form a fistula on the other side, and the successful treatment made her discharged on the 17th day. The duodenal diverticulitis with calculus is extremely rare, and there is no report to treat it using double-balloon endoscopy, therefore we report this case with a literature review.

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肠道重建后十二指肠憩室炎伴结石的双气囊内窥镜检查:病例报告。
小肠憩室病比较常见,但对于伴有结石嵌顿的十二指肠憩室炎却没有固定的治疗策略。一位 70 多岁的妇女主诉腹痛,她在全胃切除术后采用 Roux-en-Y 方法重建了十二指肠。我们为她进行了增强型计算机断层扫描,结果显示十二指肠壁水肿增厚。我们诊断她患有十二指肠憩室炎,并用抗生素进行了治疗,但她的病仍未痊愈,因此我们尝试用内窥镜取石作为非手术疗法。非手术取石后,我们对十二指肠乳头状憩室进行了造影,发现它在另一侧形成了瘘管,治疗成功后,她于第 17 天出院。十二指肠憩室炎伴有结石的病例极为罕见,目前还没有使用双气囊内镜进行治疗的报道,因此我们在报告本病例的同时进行了文献综述。
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