Perforated jejunal diverticulitis as a rare cause of acute abdomen

Peters, R.; Grust, A.; Gerharz, C. D.; Dumon, C.; Fürst, G.

doi:10.1007/s003300050862

Cited by 31 publications

(23 citation statements)

References 9 publications

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“…The incidence of acquired jejunal diverticulosis is less than 1% in autopsied patients [1,2]. Jejunal diverticula are up to seven times more common than ileal diverticula and tend to be larger [1,2,6].…”

Section: Discussionmentioning

confidence: 97%

“…The condition is generally asymptomatic and is usually diagnosed incidentally during laparotomy or small-bowel enteroclysis. Complications include diverticulitis, perforation, hemorrhage and enterolith formation with secondary intestinal obstruction [1][2][3][4][5][6]. Enteroliths are stones in the gastrointestinal tract [3] and are an uncommon cause of obstruction of the small intestine.…”

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confidence: 99%

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Enterolithiasis in jejunal diverticulosis, a rare cause of obstruction of the small intestine: a case report

Kornprat

Langner

2005

Wien Klin Wochenschr

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Jejunal diverticula are rare and usually asymptomatic; they occur twice as frequently in men. They are discovered incidentally during small-bowel enteroclysis, CT scan or laparotomy. Complications include diverticulitis, perforation, hemorrhage and enterolith formation. Intestinal obstruction due to enterolithiasis is uncommon. We present the association of enterolithiasis and jejunal diverticulosis causing obstruction of the small intestine in a 74-year-old female who was admitted for abdominal cramps, nausea and vomiting. On physical examination, there was discomfort on palpation of the upper abdomen. Laboratory tests revealed mild elevation of leucocytes and C-reactive protein. CT scan demonstrated dilatated loops of proximal jejunum with thickening of the wall, suggesting ingestion of a foreign body. Clinical and radiological findings did not indicate conservative therapy; our patient underwent minilaparotomy, and pronounced jejunal diverticulosis was identified. An enterotomy was performed and a cylindrical enterolith, 10cm long and 3cm in diameter, was removed. The operative and postoperative course was uneventful. Enterolithiasis must be considered as a potential source of intestinal obstruction. The differential diagnosis should take gallstone ileus and ingestion of a foreign body into consideration. Initial therapy is nonoperative; if this management fails, surgery is indicated.

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

Enterolithiasis in jejunal diverticulosis, a rare cause of obstruction of the small intestine: a case report

Kornprat

Langner

2005

Wien Klin Wochenschr

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“…Im Labor zeigte sich auch diesmal nur eine diskrete Leukozytose von 11.800/l bei einem CRP-Wert von 9,2 mg/l. [1,4,6]. Die Entzündung der Divertikel ist die häufigste Komplikation der Jejunaldivertikulose und entsteht durch bakterielle Besiedlung im Rahmen einer intradivertikulären Stase.…”

Section: Introductionunclassified

“…Bei chronisch-unspezifischen Symptomen seht die selektive Dünndarmpassage nach Selink im Vordergrund, nachdem gastro-und koloskopische Abklärungen unauffällig waren [1,2,3,6]. Bei akutem Abdomen ist die Computertomographie die Methode der Wahl [3].…”

Section: Introductionunclassified

Mehrfach rezidivierende Diverticulitis perforata jejuni

Franzen

Gürtler

Metzger

2002

Chirurg

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Jejunal diverticulitis is a very rare cause of acute abdomen. The treatment of choice in acute perforated jejunal diverticulitis is intestinal resection with primary anastomosis of the affected area. Data on long-term results, postoperative complications and the nature of this illness is limited. To our knowledge, a recurrent perforated jejunal diverticulitis has never have been reported in the literature. In this case,we present a patient who suffered from a recurrence of perforated jejunal diverticulitis 13 weeks after the initial intestinal resection. After the second intestinal resection (due to the recurrent infection), the patient suffered from a third period of jejunal diverticulitis.

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“…2 ). The diverticula of the jejunum including the inflamed diverticulum were removed with an tions, best diagnosed by CT scan [1,2] . Even though some advocate conservative treatment with antibiotics, in cases with extended inflammation, such as described, surgical treatment is considered the best and safest choice [3][4][5] .…”

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confidence: 99%