Editing Duodenal diverticula (section)

== Management ==

* Asymptomatic diverticula should be left alone
* Symptomatic or complicated extra-luminal diverticula can be resected either endoscopically or via laparotomy and duodenotomy
* Intra-luminal diverticula generally require treatment regardless
** Can be endoscopic or open
** Even large diverticula >3cm or obstructing can be treated endoscopically, but haemorrhage or perforation generally means open is best

=== Diverticulectomy ===

* Can be done open or laparoscopic
* Wide Kocher manoeuvre to expose the duodenum
* Identify ampulla and protect
* Diverticulum excised (may need to do duodenotomy for diverticula embedded within the head of pancreas)
* Duodenum closed in a transverse or longitudinal fashion
* Omental patch can be used


=== Perforated diverticulum ===

* Excise diverticulum
* Close duodenum with a serosal patch from jejunal loop
* May be necessary to divert with a gastrojejunostomy or duodenojejunostomy if there is significant inflammation

[[Category:Small bowel]]