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from Section 8 - Retroperitoneum
Published online by Cambridge University Press: 05 November 2011
Imaging description
Duodenal diverticula are congenital anatomic variants and are found in up to 22% of the population at autopsy [1]. Fluid-filled or collapsed duodenal diverticula may mimic cystic or soft-tissue retroperitoneal or pancreatic masses at cross-sectional imaging (Figures 52.1–52.3) [2,3]. Increased uptake of FDG within a duodenal diverticulum at PET imaging has also been reported [4].
Importance
Misdiagnosis of retroperitoneal adenopathy or a pancreatic mass may result in unnecessary surgery or treatment [2].
Typical clinical scenario
Duodenal diverticula are incidental findings that are likely to cause most diagnostic confusion when seen in patients with known malignancy (when they may suggest metastatic spread) or in the postoperative period (when they may resemble an abscess).
Differential diagnosis
Duodenal diverticula can usually be diagnosed by recognizing the characteristic location near the duodenum and by examination of all available studies that may allow identification of intradiverticular air [3].
Teaching point
The possibility of a duodenal diverticulum should be considered when an apparent cystic or soft-tissue mass or collection is seen adjacent to the duodenum. Comparison with prior studies or repeat examination after oral contrast may facilitate correct diagnosis.
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