CT features of juxtapapillary duodenal diverticula with complications

Objective: We evaluated the computed tomography (CT) features of juxtapapillary duodenal diverticula (JPDD) with complications in patients who had acute abdomen. Materials and Methods: Nineteen JPDD were evaluated in 14 patients (mean age: 50 years), who had acute abdomen on contrast-enhanced helical CT with a diagnosis of complicated JPDD by endoscopic retrograde cholangiopancreatography (ERCP). The size, number, and contents of the JPDD, pacreticobiliary ductal dilation, biliary stones, and other associated findings were evaluated on CT scans. Results: Eighteen of the 19 JPDD (94.4%) containing air were demonstrated by CT. Their diameter ranged from 20 to 40 mm (mean: 30 mm). Common bile duct dilation was visualized in 12 patients and biliary stones were found in 8 patients. The other findings were cholecystitis, cholangitis, pancreatitis, and liver abscess. The most serious complication was perforation into the retroperitoneal space caused by diverticulitis associated with an enterolith. Conclusion: Complicated JPDD were well depicted on CT scans, and various findings were revealed. CT evaluation of complicated JPDD was useful for management of these patients.