{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:41:14Z","timestamp":1768437674614,"version":"3.49.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2016,10,22]],"date-time":"2016-10-22T00:00:00Z","timestamp":1477094400000},"content-version":"vor","delay-in-days":295,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>The duodenum is the second most common location of intestinal diverticula following the colon (Juler et al., 1969) [1]. Only 1\u20135% of patients with duodenal diverticula become symptomatic (Oukachbi, 2013) [2]. The least common but most serious complication of duodenal diverticula is perforation, which has a mortality rate of 20% (Oukachbi, 2013; Yin et al., 2001; Song, 2015; Schnueriger et al., 2008) [2\u20135].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PRESENTATION OF CASE:<\/jats:title>\n                    <jats:p>A 65 year old female presented with sudden onset periumbilical and epigastric pain. Her abdomino-pelvic CT without contrast revealed a duodenal perforation of the anterior wall of the duodenum. After attempting a laparoscopic approach, the operation was converted to an open procedure to enhance visualization. A wide Cattell-Braasch maneuver was performed, mobilizing the duodenum, which revealed an inflamed diverticulum. Following a pyloric exclusion, a gastrojejunostomy and a Braun enteroenterostomy were completed in addition to a jejunostomy tube on the efferent limb.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Clinical presentation of duodenal diverticula is vague and often varies. Although difficult to elucidate on imaging, the most sensitive exam to detect a duodenal diverticulum perforation is an abdominal CT scan, which can reveal thickened bowel wall, mesenteric fat stranding, and an extraluminal, retroperitoneal collection of air or fluid (Song, 2015) [4]. Due to the rareness of perforated duodenal diverticulum, surgical treatment guidelines are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Ultimately, it is necessary to have a high index of suspicion to detect a duodenal diverticulum perforation. The perforation usually necessitates operative treatment that consists of a diverticulectomy and two-layer closer of the duodenum, Kocher maneuver, and drainage of the retroperitoneum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2016.10.049","type":"journal-article","created":{"date-parts":[[2016,10,23]],"date-time":"2016-10-23T10:00:36Z","timestamp":1477216836000},"page":"100-102","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Perforated duodenal diverticulum case report"],"prefix":"10.1097","volume":"29","author":[{"given":"Julie","family":"Glener","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephenie","family":"Poris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Foles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhonda","family":"Harmon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-26-20260114","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1001\/archsurg.1969.01340170024006","article-title":"Perforating duodenal diverticulitis","volume":"99","author":"Juler","year":"1969","journal-title":"Arch. Surg"},{"key":"R2-26-20260114","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jviscsurg.2013.04.006","article-title":"Management of complicated duodenal diverticula","volume":"150","author":"Oukachbi","year":"2013","journal-title":"J. Visc. Surg"},{"key":"R3-26-20260114","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1007\/s00268-001-0039-y","article-title":"Clinical analysis and literature review of massive duodenal diverticular bleeding","volume":"25","author":"Yin","year":"2001","journal-title":"World J. Surg"},{"key":"R4-26-20260114","doi-asserted-by":"crossref","first-page":"159","DOI":"10.4166\/kjg.2015.66.3.159","article-title":"Management of perforated duodenal diverticulum: report of two cases","volume":"66","author":"Song","year":"2015","journal-title":"Korean J. 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Gastroenterol"},{"key":"R8-26-20260114","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1272\/jnms.71.337","article-title":"Simple closure of a perforated duodenal diverticulum: a case report","volume":"71","author":"Yokomuro","year":"2004","journal-title":"J. Nippon Med. Sch"},{"key":"R9-26-20260114","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.ijscr.2014.06.008","article-title":"Perforated duodenal diverticulum: surgical treatment and literature review","volume":"5","author":"Costa Sim\u00f5es","year":"2014","journal-title":"Int. J. Surg. 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