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The duodenum is the second most common site for gastrointestinal diverticulum.1 Patients with duodenal diverticula are often asymptomatic.1–3 Diagnosis of this condition is often made incidentally in 14.5% of barium examinations of the upper gastrointestinal tract. Prevalence of this condition is reported to be 22% of cadavers on autopsy.1  The clinical presentation is typically characterized by non-specific abdominal symptoms.3 However, patients can present with symptoms of duodenal diverticulitis, perforation, bleeding, cholelithiasis, ascending cholangitis, ulceration or intestinal obstruction.1,2 Computed tomography (CT) or magnetic resonance imaging (MRI) is usually diagnostic for DD when diverticulum is filled completely with gas or a combination of fluid and gas.3 Lack of either gas or oral contrast within these lesions makes distinction from cystic pancreatic masses challenging, and further evaluation with upper gastrointestinal barium examination may prove diagnostic.1  A case of symptomatic DD is reported here misinterpreted as a cystic tumour of pancreas on preoperative images.

Juxtapapillary duodenal diverticulum masquerading as a cystic pancreatic neoplasm