Imaging of intraluminal duodenal diverticulum in adults, an infrequent entity: pictorial essay

• Published in: Egyptian journal of radiology and nuclear medicine 2024-12, Vol.55 (1), p.227-6
• Main Authors: Whittle, Carolina, Maldonado, Ignacio, Campos, Oscar, Orellana, Franco
• Format: Article
• Language: English
• Subjects: Abdomen; Adults; Barium; Barium upper gastrointestinal; Contrast agents; Contrast media; CT imaging; CT-duodenum; Diagnostic imaging; Diverticulum; Duodenal diverticulum; Duodenum; Endoscopy; Genetic disorders; Intraluminal duodenal diverticulum; Small intestine; Tomography; Ultrasonic imaging; Windsock sign
• ISSN: 0378-603X; 2090-4762
• DOI: 10.1186/s43055-024-01387-9

Background An intraluminal duodenal diverticulum (IDD) is an infrequent abnormality consisting of a sac-like projection within the duodenum secondary to a congenital web of the membrane in the second portion of the duodenum near the papilla of Vater, due to incomplete lumen recanalization of the embryological foregut, with a typical imaging appearance of a "windsock." The purpose is to present the radiological and tomographic findings characteristics of "IDD." Results The IDD in barium upper gastrointestinal imaging and computed tomography (CT) was presented. On upper barium gastrointestinal examination, it is possible to detect an intraluminal duodenal image, that can be distended with gas or barium contrast and delimited by a thin wall (halo sign), mimicking a windsock or a double lumen. On CT, it is possible to identify a windsock sign on the duodenum, most often on the second part, distended by gas and contrast agent. Conclusion IDD imaging in barium upper gastrointestinal imaging and CT is pathognomonic of this infrequent entity in adults that needs to be recognized by the radiologist. In our small series, IDD images of the windsock sign on barium studies and the characteristic presentation on CT can help to exclude another duodenal conditions, guiding appropriate management.