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Medical Author:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• What is a duodenal diverticulum?
• What causes a duodenal diverticulum?
• What complications are caused by a duodenal diverticulum?
• How is a duodenal diverticulum diagnosed?
• How is a duodenal diverticulum treated?
• What about intramural diverticula?
• Find a local Gastroenterologist in your town
• Duodenal Diverticulum Index

The cause of extramural diverticula is not definitely known; however, they are believed to be acquired (not present from birth) due to a herniation (protrusion) of the duodenum through a defect in the muscle of the wall of the duodenum, perhaps in an area where arteries pass through the intestinal muscle to nourish the lining of the intestine.

Extramural diverticula usually cause no symptoms. Occasionally, they may rupture (just like colonic diverticula) and lead to a pocket of inflammation adjacent to the duodenum with or without infection. This may result in all the signs and symptoms of intra-abdominal inflammation including pain, fever, and abdominal tenderness.

If the diverticulum is very close to the Ampulla of Vater, patients more frequently develop gallstones, particularly in the bile duct, and may develop all of the complications of gallstones:

• biliary colic (the typical pain of obstruction of the bile ducts),
• cholecystitis (inflammation of the gallbladder), and
• cholangitis (inflammation of the bile ducts due to the spread of bacteria into the ducts from the duodenum).

Pancreatitis also may occur. These complications are believed to be due to interference by the diverticula with the normal function of the bile and pancreatic ducts.