Juxtapapillary duodenal diverticulitis in an elderly female

We describe the case of an 82-year-old Caucasian woman who presented to our institution as a transfer from an outside hospital with nausea, vomiting and abdominal pain with CT imaging concerning for a duodenal mass or abscess in the juxtapapillary region of the second part of the duodenum. Upper endoscopy showed a non-bleeding duodenal diverticulum with purulent discharge consistent with diverticulitis. She underwent endoscopic disimpaction with irrigation and received a 14 day course of antibiotics, after which she presented for follow-up 1 month after discharge without complications. This case highlights the rarity of juxtapapillary duodenal diverticulitis, its nonspecific clinical presentation and imaging findings and the importance of early diagnosis and management to prevent severe complications including perforation.