A Case of Intraluminal Duodenal Diverticulum with Duodenal Stenosis Caused by Adult Annular Pancreas

Tomohiro Saito, Yoshinobu Yokoyama, Yutaka Ansai, Isao Shirosaki, Fumio Miura, Juichi Saito

Department of Surgery, Saito-Icho Hospital

We experienced a case of intraluminal duodenal diverticulum (IDD) complicated by adult annular pancreas. The patient was a 38-year-old woman with general fatigue, appetite loss, nausea and vomiting as the chief complaints. Hypotonic duodenography and endoscopic examination revealed stenosis in the upper part and saccular formation in the middle of the second portion of the duodenum. The findings on CT scan suggested the parenchyma of pancreas around the narrow segment of the upper part of duodenum. The operative findings proved the complication of IDD and complete annular pancreas. Simple excision of the diverticulum at its base was carried out, and conventional gastrectomy was performed with Billroth-II reconstruction. The microscopic appearance of the resected specimen was characterized by normal duodenal mucosa lining both sides of the diverticulum and the lack of proprial muscle. Only one previous case of complication of IDD and duodenal stenosis caused by annular pancreas has been reported in the Japanese literature.

Key words
intraluminal duodenal diverticulum, adult annular pancreas

Reprint requests
Tomohiro Saito Second Department of Surgery, Toyama Medical and Pharmaceutical University
2630 Sugitani, Toyama, 930-01 JAPAN

Accepted
February 12, 1992

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