TY - JOUR
T1 - Prepyloric gastric diverticulum case report
T2 - A rare anatomic abnormality with limited clinical consequences
AU - Shea, Connor
AU - Sheets, Ann
AU - Tuma, Faiz
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2022/2
Y1 - 2022/2
N2 - Introduction: and Importance: Gastric diverticula (GDs) are typically formed on the posterior wall due to congenital or acquired causes. Although diverticula are not uncommon throughout the gastrointestinal tract, GDs are the least common type, and their presence in the prepyloric area is extremely rare. GDs are frequently asymptomatic but can present with serious complications that require surgical intervention in rare cases. Case presentation: A 54-year-old woman with a history of morbid obesity, hyperlipidemia, and diabetes mellitus (DM) presents with acute onset left upper quadrant (LUQ) abdominal pain. Based on presenting symptoms, an esophagogastroduodenoscopy (EGD) was performed to evaluate possible causes of abdominal pain. Interestingly, EGD revealed a moderately sized (3 cm) prepyloric diverticulum with a small polyp surrounded by normal gastric tissue. Biopsying of the intra-diverticular polyp revealed no abnormal pathology. Further assessment with Computerized Tomographic (CT) scan identified the diverticulum but with no other related gastric or gastrointestinal changes or pathology. Clinical discussion: The diverticulum was excluded as a cause of the pain. Hence, a conservative management approach was followed with no change in status for the following three months of observation. The patient continued to report non-specific symptoms but denied further episodes of abdominal pain or serious symptoms. Conclusions: GDs present with a wide variety of symptoms making the diagnosis difficult without thoroughly examining the entire anatomic region of potential pathology. Although GDs are rare, they are easily identified via EGD or imaging modalities. However, long-term follow-up information is needed to understand this clinical entity's behavior fully.
AB - Introduction: and Importance: Gastric diverticula (GDs) are typically formed on the posterior wall due to congenital or acquired causes. Although diverticula are not uncommon throughout the gastrointestinal tract, GDs are the least common type, and their presence in the prepyloric area is extremely rare. GDs are frequently asymptomatic but can present with serious complications that require surgical intervention in rare cases. Case presentation: A 54-year-old woman with a history of morbid obesity, hyperlipidemia, and diabetes mellitus (DM) presents with acute onset left upper quadrant (LUQ) abdominal pain. Based on presenting symptoms, an esophagogastroduodenoscopy (EGD) was performed to evaluate possible causes of abdominal pain. Interestingly, EGD revealed a moderately sized (3 cm) prepyloric diverticulum with a small polyp surrounded by normal gastric tissue. Biopsying of the intra-diverticular polyp revealed no abnormal pathology. Further assessment with Computerized Tomographic (CT) scan identified the diverticulum but with no other related gastric or gastrointestinal changes or pathology. Clinical discussion: The diverticulum was excluded as a cause of the pain. Hence, a conservative management approach was followed with no change in status for the following three months of observation. The patient continued to report non-specific symptoms but denied further episodes of abdominal pain or serious symptoms. Conclusions: GDs present with a wide variety of symptoms making the diagnosis difficult without thoroughly examining the entire anatomic region of potential pathology. Although GDs are rare, they are easily identified via EGD or imaging modalities. However, long-term follow-up information is needed to understand this clinical entity's behavior fully.
KW - Asymptomatic diverticulum
KW - Case report
KW - Diverticulum
KW - Esophagogastroduodenoscopy
KW - Gastric diverticulum
KW - Prepyloric diverticulum
KW - Rare diverticulum
UR - http://www.scopus.com/inward/record.url?scp=85123603089&partnerID=8YFLogxK
U2 - 10.1016/j.amsu.2022.103288
DO - 10.1016/j.amsu.2022.103288
M3 - Article
AN - SCOPUS:85123603089
VL - 74
JO - Annals of Medicine and Surgery
JF - Annals of Medicine and Surgery
SN - 2049-0801
M1 - 103288
ER -