Location: Medial (70%) descending duodenum in periampullary region, 3rd or 4th portion (26%), lateral (4%) descending duodenum

Filling defects within diverticulum (food and gas)

CT: Fluid-filled diverticulum may simulate cystic mass in pancreatic head

CT usually shows air-fluid level within “tic”

“Wind sock” appearance: Barium-filled, globular structure of variable length, originating in 2nd portion of duodenum, fundus extending into 3rd portion; outlined by thin, radiolucent line

CT: Contrast medium and gas within diverticulum, surrounded by contrast in duodenal lumen; separated by thin wall of diverticulum

May predispose to biliary sphincter incompetence, reflux, biliary stones

Makes endoscopic sphincterotomy dangerous

Symptoms and signs are indistinguishable from perforated ulcer or pancreatitis

May occur spontaneously or following instrumentation (e.g., endoscopy or passage of feeding tube)