This Article Figures Only Full Text Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hariri, A Articles by Hruban, R H Search for Related Content PubMed PubMed Citation Articles by Hariri, A Articles by Hruban, R H

Duodenal diverticulum mimicking a cystic pancreatic neoplasm

Departments of ¹ Radiology and ² Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA

Duodenal diverticula occur very commonly, with a prevalence as high as 22%. They are most frequently located in the second or third portions of the duodenum, and by nature of their proximity to the head of the pancreas, can be mistaken for cystic pancreatic neoplasms by diagnostic imaging. Patients with presumed cystic neoplasms of the pancreas often receive pancreaticoduodenectomies, which at high volume medical centres carry mortality and morbidity rates of 2–4% and 29–44%, respectively. Although most duodenal diverticula are recognized in single or repeat CT scans by the presence of air or contrast medium within the diverticula, we present a case in which serial CTs failed to yield any clue to the diverticulum's true nature and pancreaticoduodenectomy was performed. For presumed cystic lesions adjacent to the duodenum, barium studies, endoscopy, and/or endoscopic ultrasound-guided aspiration should therefore be pursued in addition to all available CT evidence prior to surgery.