Emergency surgery for jejunal diverticulosis: our experience and review of literature

Tan, Ker‐Kan; Liu, Jody Zhiyang; Ho, Choon-Kiat

doi:10.1111/j.1445-2197.2010.05480.x

Cited by 24 publications

(22 citation statements)

References 12 publications

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“…The mechanisms by which small bowel diverticular hemorrhage occurs are thought to be ulceration from diverticulitis or trauma to the mesenteric vessels [ 3 ]. Angiodysplasia, tumors, or parasitic infection [ 3 , 25 ] has also been reported to be associated with diverticular hemorrhage. In this series, both ulcers and Dieulafoy-like lesions were most commonly associated with bleeding, which suggested that standard endoscopic hemostatic techniques can also be applied in this setting [ 15 , 20 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Enteroscopic Diagnosis and Management of Small Bowel Diverticular Hemorrhage: A Multicenter Report from the Taiwan Association for the Study of Small Intestinal Diseases

Chen

Chiu

Hsu

et al. 2015

Gastroenterology Research and Practice

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Small bowel diverticulum is a rare cause of gastrointestinal bleeding. The diagnosis and treatment of small bowel diverticular hemorrhage is clinically challenging before the development of deep enteroscopy. In this multicenter study from the Taiwan Association for the Study of Small Intestinal Diseases (TASSID), 608 patients underwent deep enteroscopy for obscure gastrointestinal bleeding during January 2004 and April 2010 from eight medical centers in Taiwan. Small bowel diverticular hemorrhage account for 7.89% of obscure gastrointestinal bleeding in this study. Most of the patients received endoscopic therapy with an initial hemostasis rate of 85.71% and rebleeding rate of 20%. In this large case series investigating the enteroscopic management of small intestinal diverticular hemorrhage, we found that, as to patients with peptic ulcer hemorrhage, most of these patients can be successfully managed by endoscopic therapy before surgery in the era of deep enteroscopy.

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Section: Discussionmentioning

confidence: 99%

Enteroscopic Diagnosis and Management of Small Bowel Diverticular Hemorrhage: A Multicenter Report from the Taiwan Association for the Study of Small Intestinal Diseases

Chen

Chiu

Hsu

et al. 2015

Gastroenterology Research and Practice

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“…Owing to its rarity, small bowel diverticulosis is often overlooked as a differential diagnosis. Bearing in mind that the complications of these diverticula can be catastrophic,5 it is worth considering them early in cases where there is diagnostic uncertainty. The importance in characterising jejunal diverticulae as opposed to other pathology, such as malignancy or Meckel’s diverticulum, lies in the possibility of difference in management.…”

Section: Discussionmentioning

confidence: 99%

“…This condition is commonly overlooked when considering differential diagnoses. Complications arising from these diverticulae can be catastrophic with mortality rates reported as being as high as 24%–40% 4 5…”

Section: Introductionmentioning

confidence: 99%

Non-operatively managed case of contained jejunal diverticular perforation

Jambulingam¹,

Nanayakkara

2019

BMJ Case Rep

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Jejunal diverticulosis is an underdiagnosed condition due to its relatively benign existence and uncharacteristic presentation. The complications can be very severe and, due to its often late diagnosis, patients may require urgent surgery. We present a woman who initially complained of non-specific abdominal symptoms but was diagnosed with a contained jejunal diverticular perforation relatively early. We managed her non-operatively with intravenous antibiotics from which she recovered well. She was discharged 2 days later and has remained completely well. Follow-up at 3 months showed no recurrence. Our case differs from most of the literature due to the early diagnosis and successful non-operative management of the patient. We conclude that, in cases of non-specific abdominal pain with diagnostic ambiguity, a diagnosis of small bowel diverticulosis should be considered. It should be managed non-operatively where possible.

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“…Acute presentations of jejunal diverticula are rare, but very severe. The most common acute presentations include diverticulitis, hemorrhage or intestinal obstruction secondary to intussusception or volvulus [7] . Mechanical intestinal obstruction occurs in 2.3-4.6% of cases [2] .…”

Section: Discussionmentioning

confidence: 99%