BACKGROUND The duodenum is a common site for diverticulum formation. Most of the duodenal diverticula are asymptomatic, incidental findings. Perforation is a rare but potentially lethal complication of duodenal diverticular disease. Surgery remains the mainstay of treatment for perforated duodenal diverticula. In recent years, a few cases were successfully managed either conservatively or with endoscopy. CASE PRESENTATION We present two cases of female patients treated in our department for duodenal diverticulum perforation. The first case was treated surgically with a diverticulectomy. The second case was managed conservatively with bowel rest and intravenous antibiotics. Both patients had an uncomplicated postoperative course and were discharged home. CONCLUSIONS Both surgical and conservative treatments are viable options for a perforated duodenal diverticulum in selected patients. Patients with a contained duodenal diverticular perforation can be managed conservatively at the outset. Possibly, the introduction of a classification system for duodenal diverticulum perforation may help clinicians in making essential therapeutic decisions.

中文翻译：

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十二指肠憩室穿孔的具有挑战性的诊断和治疗：两例报道。

背景技术十二指肠是憩室形成的常见部位。多数十二指肠憩室无症状，偶然发现。穿孔是十二指肠憩室病的一种罕见但可能致命的并发症。外科手术仍然是十二指肠憩室穿孔的主要治疗手段。近年来，通过保守治疗或内镜检查成功治愈了少数病例。病例介绍我们介绍了在我科接受十二指肠憩室穿孔治疗的两名女性患者。第一例经憩室切除手术治疗。第二例采用肠道休息和静脉内抗生素保守治疗。两名患者术后病程简单，均已出院。结论手术治疗和保守治疗都是选择的患者十二指肠憩室穿孔的可行选择。有十二指肠憩室穿孔的患者可以一开始就保守治疗。可能的是，引入十二指肠憩室穿孔分类系统可以帮助临床医生做出重要的治疗决策。