Ileal Diverticulitis as a Cause of Right Lower Quadrant Pain: A Case Report and Review of the Literature

Kothadia, Jiten P.; Katz, Seymour; Ginzburg, Lev

doi:10.5812/acr.20745

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…Small bowel diverticulae are commonly seen in elderly males, in the sixth to seventh decade of life [ 8 ]. Acquired small bowel diverticulae are pseudo (false) diverticulae, consisting of a thin-walled outpouching formed by the mucosa and submucosa bulging through the muscular layer as opposed to Meckel's diverticulae (congenital) which contain all layers of the intestinal wall [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

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Small Intestinal Diverticulosis: A Rare Cause of Intestinal Perforation Revisited

Ramzee

Khalaf

Ahmed

et al. 2020

Case Reports in Surgery

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Jejunoileal diverticulosis (JID) is a rare and nonspecific symptomatic disease. It is usually an acquired condition associated with false diverticula and integrated with colonic diverticulosis which can be diagnosed incidentally or later with complications. A sixty-nine-year-old male presented with sudden onset generalized abdominal pain. Computed tomography (CT) imaging was suggestive of ileal diverticulitis with localized perforation. The patient was treated conservatively with IV fluids and antibiotics and kept nil per orem for three days and discharged after symptoms subsided. The patient returned with a similar presentation but with a greater intensity. CT with oral contrast revealed evidence of distal ileal perforation. The terminal ileum was resected, and a double barrel ileostomy was created. Six months later, the stoma was reversed after resecting 50 cm of proximal terminal ileum which included all diverticula. The patient had a smooth postoperative recovery. Small bowel diverticulitis is generally managed conservatively unless the patient’s clinical condition mandates urgent exploration. This report may add knowledge and lead to a change in clinical practice.

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Section: Discussionmentioning

confidence: 99%

“… WBC: white blood cell count; NA: not available; RUQ: right upper quadrant; RLQ: right lower quadrant; LLQ: left lower quadrant; CT: computed tomography; references: [ 4 , 5 , 7 , 8 , 10 , 16 – 21 ]. …”

Section: Figurementioning

confidence: 99%

Small Intestinal Diverticulosis: A Rare Cause of Intestinal Perforation Revisited

Ramzee

Khalaf

Ahmed

et al. 2020

Case Reports in Surgery

View full text Add to dashboard Cite

show abstract

“…However, early surgical treatment represents the approach of choice for patients with confirmed diverticulitis and serious complications. Of note, a delayed diagnosis of this clinical entity has a high morbidity and mortality rate [ 10 ]. All the cases presented here were perforated or had a penetrated status.…”

Section: Discussionmentioning

confidence: 99%

Penetration and Perforation of Terminal Ileum Diverticulitis

Saijo

Sawada

Nomura

et al. 2020

Case Reports in Surgery

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Background. Terminal ileum diverticulitis is a rare clinical disease. It can frequently mimic other processes, such as acute appendicitis. Diagnosis and therapeutic decision making (surgical or conservative treatment) can be complex. We report four interesting cases of terminal ileum diverticulitis. Case Presentation. Case 1: a 55-year-old male presented to us with a 3-day history of severe right lower quadrant pain. Computed tomography (CT) showed penetration of terminal ileum diverticulitis. Following a 7-day conservative treatment, he underwent ileocecal resection. Pathology results revealed a false diverticulum and two in five points of perforated terminal ileum diverticulum. Case 2: a 77-year-old male presented to us with severe right lower quadrant pain and unconsciousness. CT showed penetration of terminal ileum diverticulitis and air in the mesentery. Ileocecal resection was performed 2 days postadmission. Pathology results revealed a false diverticulum and penetrated terminal ileum diverticulum. Case 3: a 61-year-old male presented to us with a right lower quadrant pain for 10 days and fever for 6 days. CT showed penetration of terminal ileum diverticulitis and abscess of the psoas muscle. Puncture and drainage of abscess were performed. Laparoscopic ileocecal resection was performed 30 days postadmission. Pathology results revealed a false diverticulum and penetrated terminal ileum diverticulum. Case 4: a 39-year-old female presented to us with right lower quadrant pain for 9 days, suspicious of appendicitis. CT showed abscess of pericecal area. Puncture and drainage were performed. A drainage tube was located into the cecum through the terminal ileum. Conservative therapy was effective, and she was discharged 23 days postadmission. Conclusions. All four cases had right lower quadrant pain. Three cases were diagnosed by CT, whereas one was diagnosed by abscess drainage. Two cases required surgical treatment within 3 days, one within about 1 month, and one case did not require surgery. The decision of whether to manage a patient surgically or conservatively is difficult. It is critical not to delay the decision of performing a surgical treatment until each patient reaches a stable general condition.

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Ileal Diverticulitis as a Cause of Right Lower Quadrant Pain: A Case Report and Review of the Literature

Cited by 2 publications

References 14 publications

Small Intestinal Diverticulosis: A Rare Cause of Intestinal Perforation Revisited

Small Intestinal Diverticulosis: A Rare Cause of Intestinal Perforation Revisited

Penetration and Perforation of Terminal Ileum Diverticulitis

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