Paravaterian diverticula presenting as acute cholangitis in two very elderly patients.

Paravaterian diverticula are extraluminar outpouchings of the duodenal lumen arising in a range of 2-3 cm from the ampulla of Vater. Their prevalence increases with age. Complications include pancreaticobiliary complications (primary calculosis of the biliary tract; cholangitis; acute pancreatitis) and non-pancreaticobiliary complications (bleeding; perforation; obstruction). The association between diverticula and the listed pathologies is not univocal and the pathophysiology that leads to the single pancreatico-biliary complication is not well understood. We report two cases of very old patients presenting with epigastric pain, fever and a laboratory pattern of acute cholangitis related to the presence of paravaterian diverticula.