Jejunal diverticular disease: a report of three cases (original) (raw)
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Analysis of clinical manifestations of symptomatic acquired jejunoileal diverticular disease
World journal of gastroenterology : WJG, 2005
To analyze systematically our experience over 22 years with symptomatic acquired diverticular disease of the jejunum and ileum, exploring the clinical manifestations and diagnosis of this rare but life-threatening disease. The medical records of patients with surgically confirmed symptomatic jejunoileal diverticular disease were retrospectively reviewed. Data collected included demographic data, laboratory results, clinical course (acute or chronic), preoperative diagnosis, and operative findings. Inclusion criteria were as follows: (1) surgical confirmation of jejunoileal diverticular disease and (2) exclusion of congenital diverticula (e.g. Meckel's diverticulum). From January 1982 to July 2004, 28 patients with a total of 29 operations met the study criteria. The male:female ratio was 14:14, and the mean age was 62.6+/-3.5 years. The most common manifestation was abdominal pain. In nearly half of the patients, the symptoms were chronic. Two patients died after surgery. Only f...
Jejunal diverticulae: reports of two cases with review of literature
Indian Journal of Surgery, 2009
Introduction Jejunal diverticulosis (JD) is a rare disease of elderly people. Majority of diagnosed individuals are asymptomatic and found incidentally. The disease is clinically signifi cant because of associated potential risk of serious complications. Due to the rarity and variable presentation of this clinical entity, diagnosis is often diffi cult and delayed, resulting in unnecessary morbidity and mortality. Clinical presentations, signs, diagnosis, complications and treatment of JD are discussed through a review of the literature and report of two cases. Methods A literature review was done for analysis of diagnosis, treatment and complications of JD. Two cases of JD diagnosed and treated in our institution are also presented. Conclusion JD is a rare disease which has variable presentations and thus poses a challenge to our diagnostic skills. Awareness about complications and presentation of the condition is needed for early detection and avoiding unnecessary mortality.
Jejunal diverticulosis: a rare case of intestinal obstruction
Journal of Surgical Case Reports, 2016
Small bowel diverticulosis represents an uncommon pathology that is often misdiagnosed, since it causes non-specific gastrointestinal symptoms. It is defined by the existence of multiple diverticula, which are located most frequently in the jejunum. Diagnosis often occurs following the presentation of related complications such as diverticulitis, haemorrhage, perforation or obstruction. Intestinal obstruction can be caused by inflammatory stenosis due to repeated episodes of diverticulitis, volvulus, intussusception or the presence of enteroliths. Here, we report a case of multiple jejunal diverticula causing acute intestinal obstruction.
A Case of Obstruction Due to Jejunoileal Diverticula
Journal of Gastrointestinal Surgery, 2011
Objective The objective of this study is to discuss the presentation and diagnosis of a complicated jejunoileal diverticuli. Case Report The case of a 94-year-old woman with small bowel obstruction secondary to an impacted enterolith from a jejunoileal diverticulum is presented to illustrate the clinical picture and radiographic findings of complicated small bowel diverticula.
Isolated Jejunal Diverticulosis an Incidental Finding: A Case Report
Jejunal diverticulosis is a rare entity involving small bowel. The condition is usually asymptomatic and diagnosed incidentally, although it may cause chronic symptoms and acute complications. Because of the rarity of the condition, diagnosis is often delayed. The condition should be suspected in cases of unexplained chronic pain abdomen and malabsorption to avoid unnecessary mortality and morbidity. We are thereby reporting a 40 yr old male patient who presented to surgical emergency with acute abdomen. He used to take NSAIDS for chronic back pain. On exploration thin walled jejunal diverticulae of size 5x5 cm were observed along with a prepyloric gastric perforation. Modified graham's omental patch repair was done for the gastric perforation, decision for conservative approach was made for diverticulosis segment. During the followup OPD visits, patient underwent upper GI endoscopy, colonoscopy, Barium meal follow through and USG abdomen. Barium meal follow through showed multiple diverticulae, rest all investigations were normal. Patient was followed up for 10 months postoperatively and no complications were observed. Thus we concluded that incidentally diagnosed diverticulosis could be left alone without any intervention, managing chronic symptoms medically.
Acquired jejuno-ileal diverticular disease: a diagnostic and management challenge
Anz Journal of Surgery, 2003
Background : Acquired jejuno-ileal diverticular disease (JID), a result of abnormalities in the smooth muscle or myenteric plexus of the small bowel, is less rare than was once believed. Approximately 1.3% of the population has JID, of whom approximately 10% present with life-threatening complications such as inflammation, perforation, bleeding, obstruction and malabsorption. Jejuno-ileal diverticular disease can be diagnostically and therapeutically challenging, and complications are often diagnosed only at laparotomy, while the best management is not agreed on in the literature. To increase the awareness of this condition and its complications, the Auckland Hospital's experience of JID was reviewed. Methods : Retrospective review was carried out of the audit data and the discharge coding records of Auckland Public Hospital for the 5 year period leading to November 2001. Results : Nine cases with a variety of presentations were found. Those cases are described and a literature review of JID is provided. Conclusion : Jejuno-ileal diverticular disease should be included in the differential diagnosis when dealing with surgical emergencies in the elderly presenting with features of bowel perforation, obstruction or bleeding.
Enterolith Small-Bowel Obstruction Caused by Jejunal Diverticulosis: Report of a Case
Surgery Today, 2006
tal segment. The incidence of jejunal diverticulosis in the general population ranges from 0.02% to 7.1%. 2-4 In most cases, the enteroliths are relatively small and pass into the colon without causing any symptoms. We report an unusual case of acute small-bowel obstruction, which was treated surgically after initial unsuccessful conservative treatment. Case Report A 78-year-old man presented with abdominal colicky pain, nausea, vomiting, and failure to pass flatus and feces. Physical examination revealed a distended but soft abdomen with mild tenderness, especially in the center, audible peristaltic waves, and normal body temperature and blood pressure. He had underlying diabetes mellitus, coronary artery disease, and benign prostatic hyperplasia. An erect abdominal radiograph showed multiple air-fluid interfaces in the small intestine, and an abdominal ultrasound showed nephrolithiasis of the right kidney and multiple diverticula in the urinary bladder, without any evidence of stones in the gallbladder or dilatation of the biliary tract. We initially treated the patient conservatively by inserting a nasogastric tube for upper-intestinal decompression, a Foley tube in the urinary bladder to record urinary output, and a central venous catheter for intravenous fluid administration. We also gave him widespectrum antibiotics and proton-pump inhibitors. Clinical and radioimaging improvement was seen over the next 6 days, but a barium investigation of the intestinal tract showed a single opacity inside the terminal ileum, near the ileocecal valve, without any other abnormal findings, including the presence of smallintestine diverticula (Fig. 1). For the differential diagnosis from a possible tumor of the small intestine, computed tomography (CT) was done, which showed multiple diverticula of the descending colon and the Abstract We report the successful surgical treatment of intestinal obstruction caused by enteroliths formed in jejunal diverticula. A 78-year-old man with bowel obstruction of unknown etiology was initially managed conservatively, but suffered recurrence of the obstruction. Thus, we performed a laparotomy, which revealed multiple diverticula in the jejunum, with one enterolith inside a diverticulum and one enterolith in the terminal ileum. There was no abnormal communication between the gallbladder and the intestinal tract, excluding the possibility of a gallstone ileus. The stone in the terminal ileum could not be broken manually, so we performed an enterotomy to remove the stones. Intestinal obstruction caused by enteroliths in small-bowel diverticula is a rare event, which is difficult to diagnose and manage. To our knowledge, only 35 such cases have ever been reported.
Acute Jejenal Diverticulitis: Case Report of Uncommon Presentation
American Journal of Internal Medicine, 2021
Jejunal diverticulitis is a rare condition and often difficult to diagnose. We report a case of 68-year–old man with a history of sigmoid diverticulitis who presented to the emergency room with a one day history of acute abdominal pain of the left lower quadrant. Initial CT of the Abdomen and Pelvis revealed ileus vs early/partial small bowel obstruction mildly distended loops of the small bowel with decompressed loops of small bowel in the right lower quadrant with no distinct transition point. The patient was treated with antibiotics for presumed gastroenteritis. However, given persistent symptoms and unclear etiology a CT enterography was ordered and demonstrated jejunal diverticulitis with microperforation and a significant phlegmon surrounding the inflamed diverticulum. The patient was treated with ciprofloxacin and metronidazole and reported complete resolution of symptoms after the course of antibiotics. Jejunal diverticula are extremely rare with an incidence of 0.06% to 1.3...
A Case Report of Gaint Jejunal Diverticulosis Presenting as Recurrent Acute Abdomen
Journal of Evidence Based Medicine and Healthcare, 2015
The diverticulum of the small bowel may be congenital or acquired. 80% of diverticula occur in the jejunum, 15% in the ileum and 5% in both. (1,2,3,4) Although it is often asymptomatic, it can lead to severe complications including perforation, haemorrhage, enterolith formation, diverticulitis, and intestinal obstruction (5,6,7,8) and occur in 10%-30% of patients. We have a male aged 30yrs old came with h/o recurrent colicky pain abdomen and bilious vomiting since past 6 months (9,10,11) o/e he is anaemic, malnourished and dehydrated. P/abdomengaseous distension present, no mass palpable and no free fluid, p/r-no abnormality, plain X-ray abdomen shows multiple air fluid levels. (12) On laparotomy there are multiple giant jenjunal diverticuli with bowel distension and there is a band found attached to the middle ileum. The band is excised and the jejunum which had giant diverticula has been resected and end to end anastomosis is done. Jejunal diverticula are rare and mostly asymptomatic. Patients may have nonspecific symptoms, such as chronic abdominal pain and change in bowel habits. However, the morbidity and mortality rates may increase due to perforation, obstruction, and bleeding. If acute abdomen in jejunal diverticulosis is suspected, a laparotomy and resection & anastomosis is considered and TB abdomen must be considered in the differential diagnosis
World Journal of Emergency Surgery, 2011
Multiple diverticulosis of jejunum represents an uncommon pathology of the small bowel. The disease is usually asymptomatic and must be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain or discomfort. Related complications such as diverticulitis, perforation, bleeding or intestinal obstruction appear in 10-30% of the patients increasing morbidity and mortality rates. We herein report a case