Periampullary duodenal diverticulum

Case contributed by Charlie Chia-Tsong Hsu
Diagnosis almost certain

Axial and coronal CT images shows a diverticulum arising from the medial descending segment of the duodenum (D2). Filling defect in the diverticulum is likely to represent gas/food particle. The main pancreatic duct and the common bile duct course posteriorly to the diverticulum and drain into the true lumen, duodenum (D2). 

Case Discussion

Medial descending duodenum, periampullary region, is the commonest site for duodenal diverticulum. This is not to be mistaken for pancreatic mass. If the diverticulum communicate with the lumen of duodenum gas/food particle can be present. Fluid filled diverticulum may simulate a cystic pancreatic mass. 

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