Jejunal diverticulitis as a rare cause of abdominal pain: a case report

Khsiba, A; Bradai, Samir; Mahmoudi, Moufida; Mohamed, Asma Ben; Bradai, Jawhar; Bouzaïdi, Khaled; Mona, Medhioub; Hamzaoui, Lamine; Azouz, MM

doi:10.11604/pamj.2022.41.222.29095

Cited by 5 publications

(7 citation statements)

References 10 publications

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“…Clinically, jejunal diverticulosis is usually asymptomatic (80%) of cases. When it is symptomatic, it is manifested by nonspecific abdominal pain, transit disorders (diarrhea/constipation), and flatulence ( 1 , 7 ). Complications of jejunal diverticulosis occur in about 10% of cases, most commonly consisting of acute diverticulitis, mechanical obstruction, volvulus, perforation, peritonitis, and hemorrhage ( 1 , 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…In the case of localized limited perforation, conservative management treatment may be indicated in hemodynamically stable patients ( 4 , 7 ), with the caveat that surgery should be performed if clinical improvement is not achieved within 48–72 h. In patients with peridiverticular abscess, antibiotic treatment and image-guided drainage (CT) may theoretically be sufficient, depending on the size of the collection and the possibility of a percutaneous approach ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

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Acute complicated jejunum diverticulitis: a case report with a short literature review

Chiorescu,

Mocan,

Santa

et al. 2024

Front. Med.

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IntroductionJejunal diverticulosis is a rare condition. Most of the time, it is asymptomatic; but it can cause severe complications such as intestinal perforation, mechanical occlusion, and hemorrhage.Case presentationA patient aged 78 years, with a history of biological aortic valve prosthesis, atrial fibrillation, type 2 diabetes mellitus, and chronic obstructive pulmonary disease, presented in the emergency department for acute abdominal pain in the lower abdominal floor, nausea, and inappetence. Abdominal computed tomography revealed an inflammatory block in the hypogastrium, agglutinated small intestinal loops, fecal stasis, and air inclusions. Pulled mesentery and associated internal hernia are suspected. Exploratory laparotomy was performed, revealing an inflammatory block in the hypogastrium, whose dissection revealed inner purulent collection and the appearance of jejunal diverticulitis, a diagnosis confirmed by histopathological examination. Segmental resection of the jejunum with double-layer terminal–terminal enteroenteric anastomosis, lavage, and drainage was performed. The evolution was favorable.ConclusionBased on our brief review, the diagnosis of complicated jejunal diverticulosis is difficult and sometimes not accurately established, even by high-resolution imaging techniques, with diagnostic laparotomy being necessary for these situations. Surgical treatment should be considered before severe complications develop.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Acute complicated jejunum diverticulitis: a case report with a short literature review

Chiorescu,

Mocan,

Santa

et al. 2024

Front. Med.

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“…We assume that an elevated intraluminal pressure combined with bowel wall weakness causes these cases. While they are usually asymptomatic, they can lead to life-threatening outcomes when complicated [2,5,8,11].…”

Section: Discussionmentioning

confidence: 99%

“…In some studies, it seems that gut enterocytes have been determined to be significant targets of the COVID-19 virus. The virus can enter the cells of the ileum, colon, and esophagus by using Angiotensin-converting enzyme 2 receptors and transmembrane serine protease 2 (TMPRSS2) as a mediator [8,9]. This can lead to gut inflammation and exacerbation of inflammatory bowel diseases, causing negative effects that can worsen the disease severity in both the short and the long term [9].…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Diverticulosis and COVID-19: Awareness Is the Key: A Case Series and Review of the Literature

Bangeas,

Konstantinidis,

Chrisopoulou

et al. 2024

Medicina

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Small bowel non-Meckelian diverticulosis is a rare condition with only a few published cases despite being described over 200 years ago. In the midst of the COVID-19 pandemic, studies suggested that many patients may experience gastrointestinal manifestations. Intestinal symptoms could worsen the inflammation and infection associated with small bowel diverticulitis. Here we present three cases: one with inflammation and rupture in a COVID-19 patient and another as an asymptomatic detection. The third case involved recurrence after the first laparoscopic lavage approach. Furthermore, we provide a mini-review of the literature to emphasize the importance of considering this entity in the differential diagnosis of an acute abdomen. In the majority of cases involving small bowel diverticula, conservative management is the preferred approach. However, when complications arise, surgical intervention, including enteroctomy and primary anastomosis, may be necessary to achieve optimal outcomes.

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“…The most common symptom is non-specific postprandial epigastric discomfort. 11,12 Usually, patients present with the symptoms of complications, such as: 13 Intestinal obstruction, colicky abdominal pain, constipation, vomitings, obstruction may be due to volvulus, enterolith, adhesive band formation, perforation, fever, abdominal pain with or without signs of peritonitis, haemorrhage, melena, haematochezia, leading to iron deficiency anaemia, diverticulitis: Inflammation of the diverticulum, presents with fever and localised tenderness diverticular pain, abdominal pain in the absence of other complications, malabsorption, weight loss, anaemia and diarrhoea, flatulence Jejunal diverticulosis can be radiographically detected by CT Abdomen (IV Contrast), which reveals pouching of the mesenteric bowel border in uncomplicated instances and intestinal wall thickening in cases with diverticulitis (complicated cases of diverticulosis). A double contrast barium meal with enteroclysis is also beneficial for diagnosis, but is contraindicated in cases of acute diverticulitis or perforation.…”

Section: Discussionmentioning

confidence: 99%

Surgical correction of mid gut volvulus presenting as acute intestinal obstruction and multiple jejunal diverticula with sealed off perforation-a case report

Badipati¹,

Gunturu

Maity³

et al. 2023

Int Surg J

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Multiple diverticulosis of the jejunum is an uncommon pathology of the small bowel. The incidence of diverticulum of small intestine varies from 0.3 to 1.2%, out of which duodenal diverticula are common that jejunal. This rare jejunal diverticula is usually asymptomatic in course, which made it more difficult in establishing this diagnosis. This may rarely lead to complications such as perforation, haemorrhage, obstruction which may be due to adhesions, volvulus, and intussusception. We herein report a case of a 72-year-old female patient with no comorbidities presented to ER with complaints of abdominal distention, lower abdominal pain, vomiting for 3 days. Pre-op evaluation revealed midgut volvulus with intestinal obstruction. Explorative Laparotomy revealed multiple diverticula in jejunum. Midgut volvulus was operated by resection and anastomosis of small bowel.

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Jejunal diverticulitis as a rare cause of abdominal pain: a case report

Cited by 5 publications

References 10 publications

Acute complicated jejunum diverticulitis: a case report with a short literature review

Acute complicated jejunum diverticulitis: a case report with a short literature review

Small Bowel Diverticulosis and COVID-19: Awareness Is the Key: A Case Series and Review of the Literature

Surgical correction of mid gut volvulus presenting as acute intestinal obstruction and multiple jejunal diverticula with sealed off perforation-a case report

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