Duodenal diverticula are most often asymptomatic. However, inflammatory and infectious complications, such as uncomplicated or perforated diverticulitis, covered or free in the peritoneum, as well as compressive complications, such as acute pancreatitis or dilation of the bile ducts, can occur. In cases of complicated perforation with covered peritonitis, initial medical management is indicated, with surgery considered if the condition worsens.

Our case concerns a 55-year-old woman with a covered perforated duodenal diverticulum with poor clinical, biological, and radiological evolution after nine days of medical treatment. Treating a perforated duodenum is complex. Various surgical management approaches have been described in the literature. In our case, surgery was performed with a duodenojejunal anastomosis on a Y-loop at the duodenal orifice (Gregoire's intervention).

We will discuss the management, post-operative care, and complications following surgery.