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Duodenal diverticular abscess

By Dr.Pavan Kumar In GASTROINTESTINAL Posted October 31, 2018

Patient History : h/o loss of appetitis 6 mths weight loss 17 to 18 kg in six months bloated abdomen has undergone endoscopy, present seven days vomiting and abdomen pain on and off
Gender:Male
Age:66

-          D3 & D4 segments of duodenum show wall thickening. 
-          Lobulated localised fluid collection with air few pockets noted around the 3rd part of duodenum. It measures 9.0cms(CC) x 4.0cms(TR) x 2.8cms(AP) dimensions (Vol: 35 to 45cc). Superiorly, the abscess is extending upto the portal vein confluence and partially indenting the adjoining SMV and splenic vein. The abscess is also tracking antero-inferior to the pancreas towards the central mesentery. Inferiorly, the abscess is extending ~3.5cms below the 3rd part of duodenum. It is communicating with antero-superior wall of duodenum. It shows thin enhancing walls. Partial compression over the 3rd and 4th part of duodenum noted. Mild perimesenteric fat stranding noted. 
-          Mild to moderate dilatation of 1st and 2nd part of duodenum noted. 
-          Rest of the small bowel appears normal. 

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