Diverticulose grelique avec un enorme diverticule duodenalcomplique de cholestase

摘要

The duodenal and small bowel diverticulosis is rare. This condition is most often asymptomatic and is usually a fortuitous finding. Nevertheless, complications can arise in 5 to 20% of the cases. The main complications are peritonitis, gastro-intestinal haemorrhage, and intestinal obstruction. Besides, other complications are more specific of the duodenal juxta-ampullary diverticula. In fact, the intermittent compression of the principal biliary duct or of the bilio-pancreatic ductal convergence can be at the origin of a cholestasis symptomatic or not. We report the case of a 70-year old women, with a history of cholecystectomy 30 years ago, hospitalized for chronic abdominal pains. The biological examination revealed an anicteric cholestasis. Abdominal ultrasounds and computed tomography showed dilation ofintra and extra-hepatic biliary ducts without obstacle. Biliary-MRI showed a large duodenal peri-ampullary diverticulum. Barium follow-through revealed a duodenal and small bowel diverticulosis. In the absence of a surgical indication, a clinical and para-clinical follow-up of the patient was recommended.