Perforated jejunal diverticulitis a rare cause of acute abdomen type of article: case report
DOI:
https://doi.org/10.18203/2349-2902.isj20233353Keywords:
Pneumoperitoneum, Jejunal diverticula, Resection and anastomosis, Perforation peritonitis, False diverticulaAbstract
Jejunal diverticulosis are false diverticula which is characterized by herniation of mucosa and submucosa through muscular layer of bowel; their perforation is rare but potentially a life-threatening condition that can present as peritonitis. In this case report, a 75-year lady presented to the emergency department with complaints of generalized pain in the abdomen with multiple episodes of vomiting and signs of peritonitis. Radiological evaluation, X-ray of abdomen suggestive of pneumoperitoneum, raising suspicion of a bowel perforation. The patient was immediately resuscitated and promptly managed by surgical intervention. Intraoperatively, multiple jejunal diverticular perforations identified and managed by resection and anastomosis of affected jejunal segment. This case report outscores presentation, early diagnosis and surgical intervention in such rare and challenging cases for better outcomes. The purpose of this case report is to highlight the clinical presentation, diagnostic work up, surgical intervention and postoperative outcomes in jejunal diverticular perforation as a differential diagnosis in elderly patient with acute abdominal pain and to discuss the current management strategies based on the latest research findings.
References
Akbari ME, Atqiaee K, Lotfollahzadeh S, Moghadam AN, Sobhiyeh MR. Perforated jejunal diverticula- a rare cause of acute abdominal pain: a case report. Gastroenterol Hepatol Bed Bench. 2013;6(3):156-8.
Zager JS, Garbus JE, Shaw JP, Cohen MG, Garber SM. Jejunal diverticulosis: a rare entity with multiple presentations, a series of cases. Dig Surg. 2000;17:643-5.
Woods K, Williams E, Melvin W, Sharp K. Acquired jejunoileal diverticulosis and its complications: a review of the literature. Am Surg. 2008;74(9):849-54.
Makris K, Tsiotos GG, Stafyla V. Small intestinal non-meckelian diverticulosis: clinical review. J Clin Gastroenterol. 2009;43:201-7.
Singh S, Sandhu HP, Aggarwal V. Perforated jejunal diverticulum: A rare complication. Saudi J Gastroenterol. 2011;17:367.
Gupta S, Kumar N. Jejunal diverticula with perforation in non steroidal anti inflammatory drug user: A case report. Int J Surg Case Rep. 2017;38:111-4.
Ross CB, Richards WO, Sharp KW, Bertram PD, Schaper PW. Diverticular disease of the jejunum and its complications. Am Surg. 1990;56(5):319-24.
Johnson KN, Fankhauser GT, Chapital AB, Merritt MV, Johnson DJ. Emergency management of complicated jejunal diverticulosis. Am Surg. 2014;80(6):600-3.
Khan HS, Ayyaz M. Jejunal diverticulosis presenting as an acute emergency. J Coll Physicians Surg Pak. 2015;25(1):S20-1.
Papaziogas B, Koutelidakis J, Dragoumis D, Atmatzidis S, Giakoustidis A, Atmatzidis K. Perforated jejunal diverticulum presenting as acute abdomen. Chirurgia (Bucur). 2010;105(1):119-21.
Abdelhalim D, Kania T, Heldreth A, Champion N, Mukherjee I. Operative Management of Perforated Jejunal Diverticulitis. Cureus. 2022;14(1):e21330.
Kassir R, Boueil-Bourlier A, Baccot S. Jejuno-ileal diverticulitis: etiopathogenicity, diagnosis and management. Int J Surg Case Rep. 2015;10:151-3.
Singal R, Gupta S, Airon A. Giant and multiple jejunal diverticula presenting as peritonitis a significant challenging disorder. J Med Life. 2012;5(3):308-10.
