Resposta ao caso clinico

Duodenal diverticula are out-pouchings from the duodenal wall (intra luminal diverticulum discussed separately). They may result from mucosal prolapse or the prolapse of the entire duodenal wall and can be found at any point in the duodenum.

Demographics and clinical presentation
Duodenal diverticula are very common, found in up to 23% of asymptomatic patients, and in the vast majority remain asymptomatic throughout life. In 10% of patients, some symptoms are attributable to them, with only a minority requiring surgical intervention 2. Potential complications include : duodenal diverticulitis haemorrhage perforation abscess formation Diverticula located at the ampulla of Vater may cause difficulty for endoscopists as they attempt to cannulate the biliary system.

Pathology and classification
There are a two of types of duodenal diverticula: primary diverticulum secondary diverticulum A primary duodenal diverticulum occurs where there is prolapse of mucosa through the muscularis propria. They usually occur within the 2nd part (62%) and less commonly in the 3rd (30%) and 4th (8%) parts. Unlike secondary diverticula they are rarely seen in the 1st part. When they occur in the 2nd part, most (88%) are seen on the medial wall around the ampulla, 8% are seen posteriorly and 4% on the lateral wall. A secondary duodenal diverticulum results from prolapse of the entire duodenal wall and almost invariably occurs in the 1st part of the duodenum. These are true diverticula and are usually secondary to duodenal or peri duodenal inflammation.

Caso Clinico

Mulher 55 anos.
Dor epigástrica com alguns meses de evolução.

Royal College of Radiologists

Avoiding Errors in Radiology

In Avoiding Errors in Radiology: Case-Based Analysis of Causes and Preventive Strategies, the authors provide 118 real-life examples of interpretation errors and wrong decisions from both diagnostic and interventional radiology. In each case, the authors discuss in detail the context in which the errors were made, the resulting complications, and strategies for future prevention. The cases are organized by body region, beginning with the cranium and then moving to cases of the breast, chest and abdomen, spinal column, musculoskeletal and vascular systems.

Features: *118 case studies facilitate analysis and discussion of causes of errors and offer preventive strategies to transfer into daily practice *956 high-quality images and explanatory drawings illustrate the cases and pinpoint errors of interpretation and in decision making Avoiding Errors in Radiology is a must-have reference for anyone involved ininterpreting images for diagnosis and in making decisions in interventional radiology.