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duodenal diverticulum.

@Duodenal diverticula are a rare cause of symptoms and there mere presence is not an indication for operation. Even though duodenal diverticula may be present in 20% of the population, such patients are generally asymptomatic. Duodenal diverticula will certainly complicate management of common bile duct stones. Surgical exploration should be very uncommon and limited to significant complications such as bleeding and infection which will not respond to supportive measures. Perforation will require operation and tax the ingenuity of the surgeon. The discovery of most duodenal diverticula is incidental. Upper gastrointestinal barium examinations show up to 5% of patients will have a duodenal diverticulum (Psathakis 1994). When upper gastrointestinal endoscopic examinations became frequent, ostia in the duodenum suggesting diverticula were seen in up to 20% of patients. Therefore, duodenal diverticulum can occur and not be seen on an upper GI series. The sac is not always entered by the barium flow. More than 90% of duodenal diverticula are asymptomatic and a very small percentage of the symptomatic patients would ever require an operation. Unfortunately vague intestinal symptoms and pains have been attributed to duodenal diverticula since they are so commonly encountered during diagnostic examinations. These diverticula rarely turn out to be the cause of pain or intestinal distress. In general, duodenal diverticula should be left alone.