Small Bowel Obstruction Caused by a Bezoar in a Duodenal Diverticulum

Duodenal diverticula are often found incidentally. Similarly to colonic diverticula, though much less common, duodenal diverticula can cause complications including perforation, fistulas, and abscesses. This report describes a rare complication of small bowel obstruction secondary to a bezoar formed within a duodenal diverticulum. This 60-year-old patient presented to the ED with abdominal pain. CT imaging demonstrated a duodenal diverticulum arising from the distal portion of the duodenum (D3/D4), distal to the ampulla. She was initially managed non-operatively with bowel rest; however, on repeat CT imaging with oral contrast, she was found to have a small bowel obstruction secondary to a bezoar. She ultimately was taken to the operating room for a small bowel enterotomy and removal of the bezoar. Small bowel obstruction caused by a bezoar is a rare complication of large duodenal diverticula. While initial non-operative management is appropriate, surgical intervention should be considered in patients who fail to improve.