Presentation
Vomiting and epigastric pain.
Patient Data
In the third portion of the duodenum, there is a smoothly-marginated oval collection of barium with a thin lucent rim around it. This is an intraluminal duodenal diverticulum (windsock sign) -- contrast collects within the intraluminal diverticulum, creating a relative obstruction to the flow of barium through the duodenum.
The red arrows outline the margins of the intraluminal diverticulum. The blue arrow shows the path of barium into the blind end of the diverticulum. The obstruction is not complete; contrast also passes around the diverticulum
Case Discussion
An intraluminal duodenal diverticulum is an uncommon finding that results from incomplete recanalization of the embryonic duodenum. The elongated shape resembles a windsock found at old-fashioned airports.