{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:53:34Z","timestamp":1775058814391,"version":"3.50.1"},"reference-count":7,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,8,20]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>Perforation is the rarest complication of duodenal diverticulum but also one of its most serious complications. Mortality rate was reported to up to 30%. Clinical diagnosis is usually vague and non-specific. High clinical suspicion is important as rapid deterioration is likely. Consensus regarding management is lacking and currently guided by a small series of case reviews. Surgical treatment is historically the standard therapeutic option. However, more current literature suggests improvement in patients with non-surgical management. In this paper, we discuss a case of a patient in her early 60s who had a perforated duodenal diverticulum that was treated conservatively. It highlights the importance of a good history and a CT scan to help with diagnosis. Close clinical observation is essential to detect disease progression. A step-up approach to clinical deterioration with either percutaneous drainage or surgical management should be considered if the patient does not respond to conservative treatment.<\/jats:p>","DOI":"10.1136\/bcr-2024-259643","type":"journal-article","created":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T12:05:19Z","timestamp":1725019519000},"page":"e259643","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Perforated duodenal diverticulum treated conservatively"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5158-5401","authenticated-orcid":false,"given":"Claudine","family":"Banal","sequence":"first","affiliation":[{"name":"General Surgery, St Vincent\u2019s Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Stevens","sequence":"additional","affiliation":[{"name":"St John of God, VIC, Geelong, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,30]]},"reference":[{"key":"2025082709585475000_17.8.e259643.1","first-page":"332","article-title":"Duodenal diverticulum with retroperitoneal perforation","volume":"48","author":"Bergman","year":"2005","journal-title":"Can J Surg"},{"key":"2025082709585475000_17.8.e259643.2","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1007\/s12328-017-0736-1","article-title":"Duodenal diverticulitis accompanied by abscess formation treated successfully using an endoscopic nasobiliary drainage catheter: a case report","volume":"10","author":"Tamura","year":"2017","journal-title":"Clin J Gastroenterol"},{"key":"2025082709585475000_17.8.e259643.3","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2011.821"},{"key":"2025082709585475000_17.8.e259643.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2006.09.024"},{"key":"2025082709585475000_17.8.e259643.5","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2147\/OAEM.S168487","article-title":"Conservative treatment of duodenal diverticulitis perforation: a case report and literature review","volume":"10","author":"Kim","year":"2018","journal-title":"Open Access Emerg Med"},{"key":"2025082709585475000_17.8.e259643.6","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s00423-021-02238-1","article-title":"A systematic review of the perforated duodenal diverticula: lessons learned from the last decade","volume":"407","author":"Kapp","year":"2022","journal-title":"Langenbecks Arch Surg"},{"key":"2025082709585475000_17.8.e259643.7","doi-asserted-by":"crossref","DOI":"10.1186\/s40792-019-0738-y","article-title":"Two cases of a perforated duodenal diverticulum after gastrectomy with Roux-en-Y reconstruction","volume":"5","author":"Yagi","year":"2019","journal-title":"Surg Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-259643","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:59:04Z","timestamp":1756313944000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-259643"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":7,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,30]]},"published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1136\/bcr-2024-259643"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-259643","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8]]}}}