Diverticulite jejunal: relato de caso

Abstract

Diverticulite jejunal é doença rara que acomete principalmente os idosos. Os sintomas e sinais clínicos são inespecíficos, fato que dificulta e retarda o diagnóstico. A tomografia computadorizada é muito valiosa na definição do diagnóstico. Neste relato será apresentado um caso de diverticulose jejunal complicada com diverticulite aguda perfurada bloqueada, assim como uma discussão breve sobre diverticulite jejunal e suas complicações.

Divertículo Jejunal Perfurado - Três Estudos De Casos

“…In case the jejunal diverticula consist only of herniated mucosa and submucosa through gaps in the muscle layer, they are considered as pseudo-diverticula 1,2 . The etiology remains uncertain; however, as in colonic diverticulosis, pathogenesis includes abnormal motor innervation, smooth muscle peristalsis dysfunction and intraluminal pressure [1][2][3][4] . With disordered peristalsis, there is an increase in intraluminal pressure favoring herniation of the mucous and submucosal layers, in the mesenteric side where blood vessels penetrate the intestinal wall [1][2][3][4] .These diverticula may be associated with conditions as systemic sclerosis, visceral myopathy and neuropathy of intestinal wall 1,4 .…”

“…The jejunal diverticula are rare, with an incidence ranging from 0.3% to 2.3%, and are very less frequent than the duodenal diverticula (20% vs 70%) [1][2][3][4][5][6][7][8][9][10] . They affect mainly the elderly in the 6 th -8 th decades of life [1][2][3][4][5][6][7][8][9][10] . Up to 70% may be asymptomatic, and acute diverticulitis is the most usual presentation (2.6% to 4.6%) [1][2][3][4][5][6][7][8][9][10] .…”

“…They affect mainly the elderly in the 6 th -8 th decades of life [1][2][3][4][5][6][7][8][9][10] . Up to 70% may be asymptomatic, and acute diverticulitis is the most usual presentation (2.6% to 4.6%) [1][2][3][4][5][6][7][8][9][10] . The diagnosis is usually difficult and timeconsuming because of the nonspecific symptoms, while computed tomography (CT) is an important tool in elucidating the diagnosis [1][2][3][4][5][6][7][8][9][10] .…”

“…Up to 70% may be asymptomatic, and acute diverticulitis is the most usual presentation (2.6% to 4.6%) [1][2][3][4][5][6][7][8][9][10] . The diagnosis is usually difficult and timeconsuming because of the nonspecific symptoms, while computed tomography (CT) is an important tool in elucidating the diagnosis [1][2][3][4][5][6][7][8][9][10] . Complications occur in 6% to 30%, including acute diverticulitis, anemia, obstruction, fistula, abscess, adhesions, enteroliths, bleeding, and perforation with peritonitis [1][2][3][4][5][6][7][8][9][10] .…”

“…The diagnosis is usually difficult and timeconsuming because of the nonspecific symptoms, while computed tomography (CT) is an important tool in elucidating the diagnosis [1][2][3][4][5][6][7][8][9][10] . Complications occur in 6% to 30%, including acute diverticulitis, anemia, obstruction, fistula, abscess, adhesions, enteroliths, bleeding, and perforation with peritonitis [1][2][3][4][5][6][7][8][9][10] . The objective is to describe three cases of perforated jejunal diverticulitis, emphasizing this entity as a differential diagnosis in the elderly with symptoms of acute abdomen.…”