Open Access Journal [ doi: 10.54584/lms.2022.

6 ] Case Report

Incidental Gastric Diverticulum in an Elderly Male with Chronic Dyspepsia

Kronik Dispepsili Yaşlı Erkek Hastada İnsidental Saptanan Gastrik Divertikül

Abdirahman ALASSO1 [ ], Najib WEHLIE1 [ ], Mehmet TAHTABAŞI2 [ ], Sadettin ER1 [ ]

1
Department of General Surgery, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital,
Mogadishu, Somalia.
2
Department of Radiology, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu,
Somalia.

Article Info: Received; 06.01.2020. Accepted; 20.01.2020. Published; 20.01.2020.

Correspondence: Sadettin Er; MD, Department of General Surgery, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan
Training and Research Hospital, Mogadishu, Somalia. E-mail: [email protected]

Cite as: Alasso A, Wehlie N, Tahtabaşı M, Er S. Incidental Gastric Diverticulum in an Elderly Male with Chronic Dyspepsia.
Life Med Sci 2022; 1(1): 30-32.

Abstract
Gastric diverticula are usually asymptomatic. When symptoms surface, they are mostly upper
abdominal pain, nausea, and vomiting, while dyspepsia is less common. In this case, there was determined
as an incidental of gastric diverticula that was managed by medical treatment. 70-year-old male came to our
clinic complaining chronic epigastric pain and dyspepsia, with no known co-morbidities.
Esophagogastroduodenoscopy and tomography were performed at diagnosis. Medical treatment (proton pump
inhibitor) was started and followed because the gastric diverticulum was 2 cm below. The patient is still under
follow-up and has no clinical findings.
Keywords: Gastric diverticula, Elderly male.

Özet
Gastrik divertiküller genellikle asemptomatiktir. Semptomlar ortaya çıktığında, çoğunlukla üst karın
ağrısı, bulantı ve kusma olurken, dispepsi daha az görülür. Bu olguda da tıbbi tedavi ile yönetilen bir gastrik
divertikül insidental olarak saptanmıştır. 70 yaşında erkek hasta bilinen bir morbiditesi olmayan kronik
epigastrik ağrı ve dispepsi şikayeti ile kliniğimize başvurdu. Tanıda, özofagogastroduodenoskopi ve tomografi
yapıldı. Gastrik divertikül, 2 cm altında olduğundan medikal tedaviye (proton pompa inhibitörü) başlandı ve
takip edildi. Hasta halen takip edilmekte ve klinik bulgusu da bulunmamaktadır.
Anahtar Kelimeler: Gastrik divertikül, Yaşlı erkek.

Introduction 0.04% respectively [1,2]. The incidence of GD is

Gastric diverticulum (GD) is sac-like fifty-fifty in both sexes and mostly may present at
projection of the gastric wall sac are rare and the age from 50th up to 60th the absence of the
noticed by chance in the course of routine specific pathognomonic symptoms makes his
gastroscopy. Prevalence of GD according to the condition difficult to diagnose. In our goal was to
different diagnostic modality like endoscopy, underline on the diagnosis and dissimilar
radiographs, and autopsies 0.01%, 0.02% and treatment options for GD.

©Copyright . Licenced by Creative Commons Attribution-NonCommercial 4.0 International ( ).

 Alasso A, et al. Life Med Sci 2022; 1(1): 30-32.

Case Report esophagogastro-duodenoscopy (OGD), we found

70-year-old male came to our clinic single out pouching measuring 1-2 cm in the
complaining chronic epigastric pain and gastric fundus ( ) and also food material
dyspepsia, with no known co-morbidities, he had inside the pouch. A GD was confirmed on oral and
history of hospitalization in 1978 for this intravenous contrast computed tomography (CT).
condition, he underwent endoscopy but CT reported 1.5-2 cm GD ( ). Medical
unfortunately, he had lost the documents, and he treatment was started and followed because the
was prescribed magnesium milk for treatment at gastric diverticulum was 2 cm below. The patient
that time. We did investigations and made is still under follow-up and has no clinical findings.

Figure 1. Diverticulum seen in gastric fundus Figure 2. Computed tomography showed an

in gastroscopy. exophytic diverticulum extending from the
stomach fundus (yellow arrow).

Discussion situated on pressure which may be internal known

GD is a sac-like projection, which commonly as pulsion diverticula, or external known as
consists of in the posterior wall of the fundus, as traction diverticula [5,6]. GD may not be
mentioned in above case. GD is minimal symptomatic. However, providing those
gastrointestinal (GI) diverticula, with widespread symptoms consist of, the sick usually complain
rates with respect to upper GI contrast studies, longtime history epigastric ache, nausea,
OGD and autopsy studies is 0.04% (165/380000), vomiting, dyspepsia, and beforetime satiety.
0.01-0.11% and 0.02% (6/29900) respectively Because of the uncertain symptoms, these may
[3]. These can be classic: innate or acquired, true be related to another abdominal pathologies and
or false (GD can be categorized to two kinds precise diagnosis is usually made by chance in the
innate, or true diverticula and acquired, or false gastroscopy in 1951, after the review of 49
diverticula). A true diverticulum consists of all symptomatic cases of GD, Palmer suggested that
three layers of the intestine; lining mucosa, symptomatic diverticula are generally seen in the
muscularis and serosa. It does not contain the existence of other gastric situations like ulceration
false diverticulum muscularis and is therefore or gastritis [4,7]. Besides, it demonstrates the
very thin-walled. Innate diverticula are significance to search for another pathology both
characteristically true and compose of three in clinical terms and with biopsy. Cases with
quarters of all GD’s, while those that are acquired unexpected relationship such as malignancy or
are characteristically false [3]. Innate diverticula obstruction have been referred to in the literature.
are usually discovered throughout the rear wall of Jayarajah et al. [3] announced a case admitting
the fundus, while acquired diverticula are based in with gastric outlet obstruction who was
or close the antrum [4]. The manner of determined to have a prepyloric diverticulum on
development of a disease of false diverticula is endoscopic OGD. Fork et al. [8] reported the case

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 Alasso A, et al. Life Med Sci 2022; 1(1): 30-32.

of a 77- year-of old male who is known with GD inhibitors were showed to present some
s, who was Later on discovered to have a symptomatic relief without resolving the primary
malignant polypoid lesion developing inside it 11 pathology [1,4]. Surgical resection is
years later. On this basis, any unusual findings in recommended if the diverticulum has findings,
a GD should trigger further investigation. In this such as perforation, bleeding, or malignancy. Both
case, the patient applied to our clinic with laparoscopic and open resection are good options.
dyspeptic complaints. The diagnosis was made Surgery ranges from partial gastrectomy to
incidentally. diverticulum invagination.
The standard investigation tool is OGD. To
investigate with CT is other option, yet this is Conclusion

lesser sensitive in detection and may cause In conclusion, the symptoms of GD are often
misdiagnosis like adrenal pathology diverticulum, variable. Our patient was determined to have
which was in advance visualized on endoscopic chronic epigastric pain and dyspepsia. He was
OGD and contrast swallow. Management of GD investigated with two different modalities such as
depends on the patient profile, size, and OGD, and CT scan. After treatment, he is still on
presenting complaints, with associated regular follow up. In this manner, it was
complications. Medical management with the use concluded that non-operative treatment is also an
of medications like antacids, proton pump option for such patients.

Declaration of interest: The authors declare no conflict of interest and alone are responsible for the content
and writing of the paper.

This article previously published as: “Somalia Turkey Journal of Medical Science 2020; 1(1): 14-16.” Currently, Somalia
Turkey Journal of Medical Science was merged with Life and Medical Sciences.

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