Rarely prominent in the physician's diagnostic consciousness and referred to but briefly if at all in the medical tests, the perforated duodenal diverticulum probably deserves more interest than it receives. The two cases recently described by Munnell and Preston1 and the case reported by Curtis and O'Grady in the current issue of The Journal (p 582) serve to draw our attention co this complication associated with high mortality and morbidity.
Mentioned cursorily 300 years ago by Morgagni in his De Sedibus as a rarity, the congenital anomaly of duodenal diverticulum has been demonstrated since to be not uncommon. Some radiologists report an incidence of 5%, while some pathologists report an incidence which is even higher. Clinicians, of course, with no symptoms nor signs to guide them in the clinical diagnosis of uncomplicated diverticula, can offer no data of their own.
More relaxed in this attitude than his counterpart a