DOI: http://dx.doi.org/10.18203/2349-2902.isj20191294

An acute abdomen packed full of surprises: a case report

Ashwath Narayan Ramji

Abstract


“Acute abdomen” is a clinical diagnosis which defines the emergent nature of the condition, rather than the condition itself, and the true diagnosis is often only made after laparotomy or laparoscopy. On occasion, the final diagnosis is drastically different from what was clinically suspected. Diseases such as diverticulosis can have multiple possible pathological outcomes as a consequence of their inflammatory nature, such as stricture formation, adhesions, acute diverticulitis, diverticular abscess, perforation and even malignant transformation. Usually one of these complications will be the presenting factor with rarely another complication discovered during management, which may or may not have been symptomatic. Extremely rarely, will multiple pathological outcomes of a condition be present together. Here we report the case of a male patient who underwent laparotomy for a suspected hollow viscus perforation, with the resulting findings a bewildering surprise.


Keywords


Multiple pathologies, Acute abdomen, Jejunal diverticulosis, Diverticulosis

Full Text:

PDF

References


Cartwright SL, Knudson MP. Evaluation of Acute Abdominal Pain in adults. Am Fam Physician. 2008;77(7):971-8.

Park WM, Gloviczki P, Cherry KJ Jr, Hallett JW Jr, Bower TC, Panneton JM, et al. Contemporary management of acute mesenteric ischemia: Factors associated with survival. J Vasc Surg. 2002;35(3):445-52.

Bharucha AE, Chakraborty S, Sletten CD. Common Functional Gastroenterological Disorders Associated With Abdominal Pain. Mayo Clin Proc. 2016;91(8):1118-32.

Hanna C, Mullinax J, Friedman MS, Sanchez J. Jejunal diverticulosis found in a patient with long-standing pneumoperitoneum and pseudo-obstruction on imaging: a case report. Gastroenterol Rep (Oxf). 2015;4(4):337-40.

Kushwaha JK, Sonkar AA, Saraf A, Singh D, Gupta R. Jejunal adenocarcinoma: an elusive diagnosis. Indian J Surg Oncol. 2011;2(3):197-201.

Mayyas E, Ahmad S, Sbaihat AS, Khori F. Threatening signals in acute abdomen. Rawal Med J. 2010;35(2):160-4.

Sheridan WG, White AT, Havard T, Crosby DL. Non-specific abdominal pain: the resource implications. Ann R Coll Surg Engl. 1992;74:181-5.

Agresta F, De Simone P, Bedin N. The laparoscopic approach in abdominal emergencies: a single-center 10-year experience. JSLS. 2004;8:25-30.

Siddiqui MA, Luke FE, Sartaj S. Meckel Diverticulum in the Setting of Acute Appendicitis: A Mimic of Periappendiceal Abscess. OMICS J Radiol. 2018;7:300.

Nejmeddine A, Bassem A, Mohamed H, Hazem BA, Ramez B, Issam BM. Complicated jejunal diverticulosis: A case report with literature review. N Am J Med Sci. 2009;1(4):196-9.

Kumar, D., & Meenakshi. Complicated jejunal diverticulitis with unusual presentation. Radiology Case Reports. 2018;13(1):58–64.

Pathak P, Rehmani B, Kumar N. Jejunal Epiphany: Diverticulae, Enteroliths and Strictures. J Clin Diagn Res. 2016;10(12):1-2.

Venara A, Toqué L, Barbieux J, Cesbron E, Ridereau-Zins C, Lermite E, et al. Sigmoid stricture associated with diverticular disease should be an indication for elective surgery with lymph node clearance. J Visceral Surg. 2015;152(4):211–5.

Soran A, Harlak A, Wilson JW, Nesbitt L, Lembersky BC, Wieand HS, et al. Diverticular Disease in Patients with Colon Cancer: Subgroup Analysis of National Surgical Adjuvant Breast and Bowel Project Protocol C-06. Clin Colorectal Cancer. 2006;6(2):140-5.