Spontaneous Perforated Duodenal Diverticulum: Wait or Cut First?

Small bowel diverticula in elderly patients: a case report and review article

“…Overall, no serious complications or recurrence was observed in the majority of cases except an episode of aspiration pneumonia [ 16 ], hospital-acquired pneumonia [ 11 ], swelling of the hand joints, polyarthralgia, fatigue 3 days post-operation [ 14 ], and wound infection at suture site [ 3 , 8 ]. With that in mind, small bowel diverticula can have several complications such as bleeding, obstruction, and diverticulitis that can lead to perforation [ 32 – 34 ]. In the current paper, we provide a case of perforated jejunal diverticulitis.…”

“…In the current paper, we provide a case of perforated jejunal diverticulitis. Perforation is one of the rarest complications (2.1–7% of diverticulitis cases), but carries a great risk with high mortality rates [ 32 , 34 ] . The clinical presentation in the cases of perforation is mostly acute with symptoms and signs similar to peritonitis such as fever and severe abdominal tenderness.…”

“…The clinical presentation in the cases of perforation is mostly acute with symptoms and signs similar to peritonitis such as fever and severe abdominal tenderness. Complications of diverticula can be managed conservatively or surgically, mainly in cases of perforation [ 32 – 34 ]. The extent of resection can cause further consequences, especially in cases with extensive diseases involving large parts of the bowel.…”

Perforated Duodenal Diverticulitis: A Case Report of a Rare Surgical Entity Treated by Roux-en-Y Deriving Intestinal Patch

“…The mainstay of conservative treatment is bowel rest with or without nasogastric tube suction associated with total parenteral nutrition and intravenous broad-spectrum antibiotics [ 8 ].…”

“…In clinically stable patients with a collection strictly limited to retroperitoneal space, endoscopic drainage of the perforation could be an alternative to percutaneous drainage [ 8 ]. Drain placement endoscopically through the diverticulum, endoscopic tissue shielding using polyglycolic acid sheets and fibrin glue, or endoscopic negative pressure therapy (ENPT) have been successful non-surgical treatments in a limited number of cases published as cases reports or cases series [ 7 - 8 ].…”