Extraperitoneal rectal gunshot injuries are rare, but may be encountered in civilian practice. We report on a series of 26 such cases. The aim of the study is to attempt to evolve a treatment policy of this injury. The principles of management include the repair of rectal wound in selected cases and the formation of a diverting colostomy. Distal rectal washout and presacral drainage, although advocated by some authors, do not seem to be indispensable adjuncts to the management of these injuries.
Complicated jejunal diverticulosis is a difficult entity to diagnose, which can cause significant morbidity and mortality. We present the case of an 88-year-old female who presented with a unique complication of small bowel diverticulosis progressing to a strangulated diverticulum requiring emergency surgery. We present the case of an 88-year-old female who presented with abdominal pain associated with a new mass on a background of perforated diverticulitis and previous laparoscopic abdominal surgeries for division of adhesions. Due to high suspicion for the mass containing necrotic bowel, the patient was taken directly to theatre for an exploratory laparotomy and was found to have ischaemic small bowel secondary to a strangulated jejunal diverticulum. When evaluating the acute abdomen consideration should be given to the diagnosis of a strangulated jejunal diverticulum causing ischaemic small bowel, with a view to expedite to emergency surgery as the primary treatment.
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