Acquired jejuno‐ileal diverticular disease: a diagnostic and management challenge

El‐Haddawi, Falah; Civil, Ian

doi:10.1046/j.1445-2197.2003.02709.x

Cited by 38 publications

(48 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Mesenteric angiography can detect bleeding rates greater than 0.5 mL/min and has the advantage of therapeutic intervention through transcatheter embolization, but it has a sensitivity of 40% - 86% [17]. Angiographic embolization has been successful in some cases, but carries the risk of ischemia [18]. Our diagnostic approach in the haemodynamically stable patients presenting with lower gastrointestinal haemorrhage is endoscopy.…”

Section: Discussionmentioning

confidence: 99%

Massive rectal bleeding from acquired jejunal diverticula

2011

View full text Add to dashboard Cite

Small bowel diverticulosis is an uncommon and often asymptomatic condition that is sporadically observed during radiographic examination or laparotomy. Although it is frequently seen in duodenum, jejunal and ileal locations are very rare. The majority of patients with jejunal diverticula have no symptoms. However, they can present with a number of acute and emergent complications with a high rate of mortality. Bleeding from jejunal diverticula occurs in less than 3% - 8% of patients and often present as fresh rectal haemorrhage. This can confuse the clinician since a bleeding source in colon is far more common. We report a patient with acute massive rectal bleeding. Abdominal CT angiography demonstrated a jejunal diverticulum as the bleeding source and the patient underwent resection of the affected segment. She has since remained free of gastrointestinal bleeding.Although jejunal diverticulosis is rare, it is an important differential diagnosis for patients with gastrointestinal haemorrhage of unknown origin as it may cause extensive rectal bleeding. Abdominal CT angiography can localize the bleeding source and resection of the affected bowel and primary anastomosis is the treatment of choice.

show abstract

Section: Discussionmentioning

confidence: 99%

Massive rectal bleeding from acquired jejunal diverticula

2011

View full text Add to dashboard Cite

show abstract

“…Some cases have a history of chronic symptoms such as vague abdominal discomfort, fullness, recur rent central and upper abdominal cramping pain caused by pseudo-obstruction or bacterial overgrowth. Yet the diagnostic accuracy of complicated acute jejunal diverticulosis based on simple clinical evaluation is still extremely poor [5,6] . Abdominal CT with double-oral and intravenous contrast may allow the diagnosis based on the following findings: focal area of out-pouching of the mesenteric side of the bowel filled or not filled with feceslike materials, focal asymmetric wall thickening, or inflammatory process adjacent to a loop of jejunum [7,8] .…”

Section: Discussionmentioning

confidence: 99%

Acute ulcerative jejunal diverticulitis: Case report of an uncommon entity

Staszewicz¹,

Christodoulou²,

Proietti³

et al. 2008

WJG

View full text Add to dashboard Cite

Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. Its reported incidence varies from 0.05% to 6%. Although there is no consensus on the management of asymptomatic jejunal diverticular disease, some complications are potentially life threatening and require early surgical treatment. We report a case of an 88-year-old man investigated for acute abdominal pain with a high biological inflammatory syndrome. Inflammation of multiple giant jejunal diverticulum was discovered at abdominal computed tomography (CT). As a result of the clinical and biological signs of early peritonitis, an emergency surgical exploration was performed. The first jejunal loop showed clear signs of jejunal diverticulitis. Primary segmental jejunum resection with end-toend anastomosis was performed. Histopathology report confirmed an ulcerative jejunal diverticulitis with imminent perforation and acute local peritonitis. The patient made an excellent rapid postoperative recovery. Jejunal diverticulum is rare but may cause serious complications. It should be considered a possible etiology of acute abdomen, especially in elderly patients with unusual symptomatology. Abdominal CT is the diagnostic tool of choice. The best treatment is emergency surgical management.© 2008 The WJG Press. All rights reserved.

show abstract

“…In einer Auswertung von 19.000 Autopsien fanden sich lediglich in 0,26 % jejunoileale Divertikel [1]. Komplizierte Verlä ufe werden in der jü ngeren Literatur zunehmend hä ufiger beschrieben, was mit dem steigenden Lebensalter begrü ndet wird [3,7]. Nach Maßgabe der Autoren sollte deshalb die Dü nndarmdivertikulose zunehmend differentialdiagnostisch beim akuten Abdomen bedacht werden.…”

Section: Epidemiologieunclassified