Non-Meckel's small intestine diverticulitis presenting with obstruction and perforation

Authors

  • David E. Ayala-Garcia General Surgery and Digestive System, General Zone Hospital, Mexican Institute of Social Security, Cd. Juarez, Chihuahua, Mexico
  • Kathya Itzel Porras Doran Internal Medicine, Regional General Hospital, Mexican Institute of Social Security, Chihuahua, Mexico
  • Goretti Yáñez Ochoa General Surgery and Digestive System, General Zone Hospital, Mexican Institute of Social Security, Cd. Juarez, Chihuahua, Mexico
  • Kevin Armando Herrera Doñez General Surgery and Digestive System, General Zone Hospital, Mexican Institute of Social Security, Cd. Juarez, Chihuahua, Mexico

DOI:

https://doi.org/10.18203/2349-2902.isj20230013

Keywords:

Diverticulitis of the small intestine, intestinal obstruction, Abdominal pain, Perforation, Images

Abstract

Small bowel diverticulosis (excluding Meckel's diverticulum) is a rare condition, which predominates in older adults. It is theorized that irregular intestinal contractions lead to increased segmental intraluminal pressure, favouring diverticula formation. This diverticulum may develop life threatening complications. Clinical record of a patient who attends the emergency service of an IMSS hospital in Ciudad Juárez, including clinical symptoms, imaging, surgical management and pathological anatomy. Patient presented to the emergency room with a clinical and imaging picture of intestinal obstruction. An exploratory laparotomy was performed, finding a diverticular disease of the small intestine complicated by diverticular perforation, which was confirmed by histopathological study. Due to its high morbidity and mortality, non-Meckel's diverticulitis of the small intestine is a pathology that should be considered as a differential diagnosis in adults over 70 years of age with abdominal pain.

References

Mansour M, Abboud Y, Bilal R, Seilin N, Alsuliman T, Mohamed FK. Small bowel diverticula in elderly patients: a case report and review article. BMC Surg. 2022;22(1):101.

Rangan V, Lamont JT. Small bowel diverticulosis: Pathogenesis, clinical management, and new concepts. Curr Gastroenterol Rep. 2020;22(1):4.

Mantas D, Kykalos S, Patsouras D, Kouraklis G. Small intestine diverticula: Is there anything new? World J Gastrointest Surg. 2011;3(4):49-53.

Guediche A, Amor SB, Mnari W, Abdelaali M, Farhat W, Ammar H et al. Diverticular disease of the small bowel: a rare cause of the duodenojejunal flexure obstruction (a case report). Pan Afr Med J. 2021;38:213.

Syllaios A, Koutras A, Zotos PA, Triantafyllou E, Bourganos N, Koura S et al. Jejunal diverticulitis mimicking small bowel perforation: Case report and review of the literature. Chirurgia (Bucur). 2018;113(4):576-81.

Schiappacasse Faúndes G, Méndez Alcaman L, Sáenz Fuenzalida R, Leal Martínez E, Adlerstein Lapostól I. Enfermedad diverticular del intestino delgado no Meckel y diverticulitis del intestino delgado. Enfoque diagnóstico en la tomografía computada. Acta Gastroenterol Latinoam. 2020;50(3):311-5.

Karas L, Asif M, Chun V, Khan FA. Complicated small bowel diverticular disease: a case series. BMJ Case Rep. 2017;2017:bcr-2017-219699.

Hardon SF, den Boer FC, Aallali T, Fransen GA, Muller S. Perforated jejunal diverticula in a young woman: A case report. Int J Surg Case Rep. 2021;81(105838):105838.

Kwak JY, Park EH, Park CS, Kim JH, Han MS, Kwak JH. Uncomplicated jejunal diverticulosis with pneumoperitoneum. Ann Surg Treat Res. 2016;90(6):346-9.

Gallego Mariño A, Ramírez Batista A, Amado Martínez JA. Divertículos de intestino delgado. Revista Electrónica Dr Zoilo E Marinello Vidaurreta. 2016;41(4).

Downloads

Published

2023-01-10

Issue

Section

Case Reports