Perforated isolated jejunal diverticulum: a rare aetiology of acute abdomen

Baksi, Aditya; Gupta, Swapnil; Kumar, Sanjeev; Ray, Udipta

doi:10.1136/bcr-2013-201533

Cited by 10 publications

(18 citation statements)

References 11 publications

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“…About 10-30% of patients develop complications like perforation, obstruction, hemorrhage and diverticulitis [2,3]. There are very few case reports in the literature of jejunal diverticulosis presenting with perforation [6,7,9,10] Our patient too remained asymptomatic, until he presented with acute abdomen because of perforated diverticuli.…”

Section: Resultsmentioning

confidence: 95%

“…in India, We have found seven cases of jejunal diverticulosis reported in India, five of them presented with complications like perforation, gastrointestinal bleeding and intestinal obstruction [3,[5][6][7][8][9][10]. In this regard, a recent cadaveric study of duodenum conducted in South India showed the prevalence of 4.2% for duodenal diverticulosis [11].…”

Section: Resultsmentioning

confidence: 99%

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Jejunal Diverticulosis with Perforation – A Challenging Differential Diagnosis of Acute Abdomen: Case Report

NatarajaN

Phansalkar

Varghese

et al. 2015

JCDR

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A 56-year-old male presented with dragging upper abdominal pain of one week duration. There was a history of dyspepsia, abdominal discomfort and vomiting after meals for past one week and low grade fever associated with chills and rigors.On examination, the patient was febrile with a temperature of 99 0 F, pulse rate -110/min, blood pressure -130/90 mm Hg. Abdominal examination revealed generalized tenderness with fullness over the right hypochondrium.Laboratory work up revealed Hb-13g/dl, TLC-10,000/cu.mm, DLC -P90 L7 E1 M2, urea -49mg/dl, creatinine -0.5mg/dl. Abdominal radiograph revealed air under the diaphragm. Abdominal CT scan and ultrasound showed multiple diverticuli in the small intestine [Table/ Fig-1] and air under the diaphragm suggesting perforation.Emergency midline laparotomy was performed. Intra-operatively multiple jejunal diverticuli were found on the mesenteric border. They were located between 8 cm to 20 cm from duodeno-jejunal (DJ) flexure. Serosal purulent exudates and multiple inter-loop adhesions were noted. There was purulent material in the peritoneum as well. Proximal jejunal resection with end to end anastomosis was done. The post operative period was uneventful and the patient was discharged on 10 th day after the surgery. One month follow up was uneventful.Gross examination of resected specimen revealed a segment of small bowel, 65 cm in length with eight outpouchings on the serosal aspect along the mesenteric border, of which largest measured 4x3x1 cm with focal areas of exudates on the serosal aspect and adhesions; smallest measured 2x1.5x0.5cm [Table/ Fig-2]. Three ABStRACtMultiple diverticulosis of the jejunum represents a very rare entity. Jejunal diverticula are found to be the rarest of all small bowel diverticula. The disease is usually asymptomatic and often becomes clinically relevant when complicated. This rarity makes it a difficult differential diagnosis. Related complications such as diverticulitis, perforation, and bleeding and/or intestinal obstruction appear in about 10-30% of the patients which increase the morbidity and mortality rates in such individuals. Here, we present a case of jejunal diverticulosis with perforation who presented with symptoms of acute abdominal pain, vomiting and fever along with a brief review of literature.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Jejunal Diverticulosis with Perforation – A Challenging Differential Diagnosis of Acute Abdomen: Case Report

NatarajaN

Phansalkar

Varghese

et al. 2015

JCDR

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“…They usually arise along with other diverticulae elsewhere in the abdomen such as the colon in up to 75% (30-75%) of cases which may suggest a potential connective tissue disorder [6,7]. They are rarely solitary (1). Their size varies between a few millimeters to greater than ten centimeters [2].…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomography is the most useful diagnostic imaging modality in diagnosing jejunal diverticula most often demonstrating jejunal thickening, inflammation or localized abscess formation [1,3,5]. Nevertheless currently, direct visualisation of diverticula via explorative laparoscopy or laparotomy is the only way of confirmation.…”

Section: Discussionmentioning

confidence: 99%

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Perforated Diverticulum of the Proximal Jejunum with Abscess

Janež¹

2017

MJCCS

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We present a case of an older male patient, who was referred to our department due to long lasting abdominal pain. He had undergone abdominal X-ray, US and CT with contrast but the underlying cause could not have been unequivocally determined. The patient underwent an explorative laparotomy during which an abscess as a consequence of perforated jejunal diverticulum has been found and successfully evacuated.

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