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Jejunal diverticulosis and chronic pneumoperitoneum
Gastrointestinal Radiology
|April 15, 1979
Summary
Jejunal diverticulosis can cause recurrent pneumoperitoneum without peritonitis or perforation. This condition may arise from gas equilibration across a distended diverticular mucosa.
Area of Science:
- Gastroenterology
- Abdominal Imaging
Background:
- Pneumoperitoneum, the presence of air in the abdominal cavity, typically indicates a surgical emergency due to bowel perforation.
- Non-surgical causes of pneumoperitoneum are less common but require careful consideration.
Observation:
- A unique case of chronic, recurrent pneumoperitoneum is detailed, notably without signs of peritonitis or bowel perforation.
- The pneumoperitoneum persisted over years and recurred even after a partial small bowel resection.
Findings:
- Jejunal diverticulosis was identified as the underlying cause of the pneumoperitoneum.
- This finding highlights jejunal diverticulosis as a significant gastrointestinal etiology for pneumoperitoneum in the absence of perforation or surgery.
- A proposed mechanism involves gas transmural equilibration through a distended diverticular mucosa, acting as a semipermeable membrane.
Implications:
- This case broadens the differential diagnosis for pneumoperitoneum, emphasizing the need to consider jejunal diverticulosis.
- It suggests that conservative management may be appropriate for pneumoperitoneum attributed to jejunal diverticulosis, avoiding unnecessary surgical intervention.
- Further research into the pathophysiology of gas transmural equilibration in diverticular disease is warranted.