Complicated jejunal diverticulitis: a challenging diagnosis and difficult therapy

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Abdominal Surgery

Background:

• Jejunal diverticulosis is a rare condition, distinct from colonic diverticulosis.
• It often presents with diverse symptoms, complicating early diagnosis.
• Clinical relevance typically arises after acute exacerbations like bleeding or perforation.

Purpose of the Study:

• To analyze the clinical presentation, surgical management, and outcomes of complicated jejunal diverticulitis.
• To evaluate diagnostic challenges and treatment strategies for this rare condition.

Main Methods:

• Retrospective analysis of prospectively collected data over 6 years (2004-2010).
• Inclusion criteria: patients treated for complicated jejunal diverticulitis (hemorrhage or perforation).
• Data included patient demographics, clinical presentation, surgical procedures, and outcomes.

Main Results:

• Nine elderly patients (median age 82) were treated for complicated jejunal diverticulitis.
• Perforation occurred in 5 patients; hemorrhage in 2 required transfusion.
• Diagnosis often required exploratory laparotomy; treatment involved diverticulectomy or segment resection.
• No in-hospital mortality; complications included wound issues and pleural effusions.

Conclusions:

• Complicated jejunal diverticulitis presents non-specifically, often requiring intraoperative diagnosis.
• Surgical resection of affected segments or all diverticula is the therapeutic goal.
• Treatment approach depends on disease extent and intraoperative findings.