1. Jejunal diverticulosis complicated with perforation: A rare acute abdomen etiology
- Author
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Ugur Topal, Kubilay Dalci, Ahmet Gokhan Saritas, Kivilcim Eren Erdogan, Atılgan Tolga Akçamı, Ismail Cem Eray, and Çukurova Üniversitesi
- Subjects
Abdominal pain ,medicine.medical_specialty ,Perforation ,business.industry ,Perforation (oil well) ,Anastomosis ,Diverticulitis ,medicine.disease ,Asymptomatic ,Article ,Diverticulosis ,Surgery ,Jejunal ,03 medical and health sciences ,0302 clinical medicine ,Acute abdomen ,030220 oncology & carcinogenesis ,medicine ,Diverticular ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Rare disease - Abstract
Highlights • Physicians treating this heterogeneous disease need to know the complex underlying mechanisms as well as the multiple management options. • Operative approach is still the definitive treatment and can be preferred to improve patients’ quality of life and to prevent more severe symptoms from developing. • Rare and difficult diagnosis of jejunal diverticulum perforation in elderly patients presenting with acute abdomen should be considered in the differential diagnosis., Introduction Jejunal diverticulosis is a rare intestinal pathology with an incidence of 0.5–1%. While most cases are asymptomatic, 30–40% of the cases may become symptomatic with chronic abdominal pain, malabsorption, hemorrhage, diverticulitis, obstruction, abscess formation and, rarely, diverticula perforation. It is generally localized on the mesenteric side and it develops from the entry points of the vessels into the jejunum. Case presentation Case 1 – A 36-year Case 2 a 75 old female patient patient was admitted to the emergency department with the complaint of widespread abdominal pain, Case 1 8 diverticules, one with diverticule perforation, was observed in the jejunum segment between the 50th and 90th centimeters after the Treitz Ligament. Case 2 – In the diverticulum 100 cm distal from the Treitz ligament, mesenteric perforation area of 4–5 mm were observed. Results Segmentary small bowel resection and side-by-side anastomosis were performed in these cases. In the histopathological examination, the Diverticula were seen to be pseudodiverticullar lesions including herniation of the mucosa and submucosa. Conclusion Jejunoileal diverticulosis is a rare disease with life-threatening complications such as perforation, obstruction and bleeding, it is usually asymptomatic or presents with nonspecific symptoms. It should be considered in the differential diagnosis of acute abdomen.
- Published
- 2019