Jejunal Diverticulosis Presented with Acute Abdomen and Diverticulitis Complication: A Case Report

Fidan, Nurdan; Mermi, Esra Ümmühan; Acay, Mehtap Beker; Murat, Muammer; Zobacı, Ethem

doi:10.12659/pjr.895354

Cited by 12 publications

(16 citation statements)

References 10 publications

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“…Two cases required surgical therapy within 3 days, one case within about 1 month, and one case did not need surgery. Several earlier reports suggested that a conservative management may be sufficient to treat uncomplicated terminal ileum diverticulitis without perforation [ 8 , 9 ]. However, early surgical treatment represents the approach of choice for patients with confirmed diverticulitis and serious complications.…”

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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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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“…In 2003, El-Haddawi and Civil presented a series of five patients with perforated diverticula in whom radiography was unremarkable [ 2 ]. However, the erect plain film of the abdomen can potentially give information about air or fluid levels, the presence of free air in the abdomen, and dilated intestinal loops [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Perforated Jejunal Diverticulum: An Unexpected Cause of Pneumoperitoneum in a Patient Presenting with an Acute Abdomen

Martins

Galletti²,

Neto³

et al. 2018

Am J Case Rep

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Patient: Female, 74Final Diagnosis: Perforated jejunal diverticulumSymptoms: Abdominal pain • Nauseas • VomitsMedication: —Clinical Procedure: —Specialty: SurgeryObjective:Rare diseaseBackground:Jejunal diverticulosis is a rare clinical condition, and the majority of patients are asymptomatic. However, some patients can develop serious complications, including perforation. We report the case of a 74-year-old female patient with a perforated jejunal diverticulum who presented with an ‘acute abdomen’ and with pneumoperitoneum on X-ray radiography.Case Report:A 74-year-old female patient presented to the emergency department with a 24-hour history of acute onset of diffuse abdominal pain associated with nausea and vomiting. Physical examination showed signs of generalized peritonitis. The chest radiograph showed a pneumoperitoneum. An emergency laparotomy was performed, and a perforated jejunal diverticulum was identified. Resection of the involved jejunal segment and a primary jejunal anastomosis were performed.Conclusions:Perforated jejunoileal diverticula should be included in the differential diagnosis for elderly patients who present with an acute abdomen. A delay in the diagnosis can be fatal in this group of patients. Although radiographic signs, such as pneumoperitoneum, are unusual in these cases, this finding should provide a diagnostic clue for the physician.

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“…In patients who develop severe epigastric pain, one must suspect incarceration and/or obstruction [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Jejunal Diverticular Perforation Causing Small Bowel Obstruction in a Type 4 Hiatal Hernia: A Rare Case Report of a Nonagenarian Patient and Review of Relevant Literature

Biswas

Gogna

Patel

2017

Case Reports in Surgery

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Type IV paraesophageal hernia (PEH) is very rare and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a case of a 90-year-old male patient who presented at our emergency department complaining of epigastric pain that he had experienced over the past few hours and getting progressively worse. On the day after admission, his pain became severe. Chest radiography revealed an intrathoracic intestinal gas bubble; emergency exploratory laparotomy identified a type IV PEH with herniation of only the jejunum with perforated diverticula on mesenteric side through a hiatal defect into mediastinum. There are a few published cases of small bowel herniation into the thoracic cavity in the literature. Our patient represents a rare case of an individual diagnosed with type IV PEH with herniation of jejunum with perforated diverticula.

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Jejunal Diverticulosis Presented with Acute Abdomen and Diverticulitis Complication: A Case Report

Cited by 12 publications

References 10 publications

Penetration and Perforation of Terminal Ileum Diverticulitis

Penetration and Perforation of Terminal Ileum Diverticulitis

A Case of Perforated Jejunal Diverticulum: An Unexpected Cause of Pneumoperitoneum in a Patient Presenting with an Acute Abdomen

Jejunal Diverticular Perforation Causing Small Bowel Obstruction in a Type 4 Hiatal Hernia: A Rare Case Report of a Nonagenarian Patient and Review of Relevant Literature

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