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Jejunoileal diverticulosis, a rare cause of ileal perforation - Case report

Nádia Tenreiro1, Herculano Moreira1, Sílvia Silva1

  • 1Department of General Surgery, Centro Hospitalar Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508 Vila Real, Portugal.

Annals of Medicine and Surgery (2012)
|March 8, 2016
PubMed
Abstract

Insights

Jejunoileal diverticulosis (JID) is a rare condition often diagnosed late. Complications like diverticulitis and perforation require prompt surgical intervention, especially in elderly patients.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Abdominal Imaging

Background:

  • Jejunoileal diverticulosis (JID) is a rare condition characterized by acquired false diverticula in the small intestine.
  • It often coexists with colonic diverticulosis and presents with nonspecific symptoms, leading to incidental diagnosis or diagnosis after complications.
  • Complications include hemorrhage, obstruction, and diverticulitis, with or without perforation.

Purpose of the Study:

  • To highlight the diagnostic challenges and management of jejunoileal diverticulosis, particularly when presenting with acute complications.
  • To emphasize the importance of high clinical suspicion for JID complications in elderly patients.

Main Methods:

  • Case presentation of an 81-year-old man with a right lower quadrant abdominal mass, fever, and elevated inflammatory markers.
  • Diagnostic workup included CT scan revealing a cavitated lesion with an air-fluid level.
  • Surgical intervention via laparotomy and segmental enterectomy was performed due to failure of conservative treatment.

Main Results:

  • The patient was diagnosed with jejunoileal diverticulosis complicated by diverticulitis and a walled-off perforation.
  • Segmental enterectomy was successfully performed.
  • The case underscores the potential for severe complications in JID.

Conclusions:

  • Jejunoileal diverticulosis is underdiagnosed and can present with acute complications requiring immediate surgical intervention.
  • Prompt laparotomy with intestinal resection is the treatment of choice for complicated JID.
  • A high index of suspicion for perforation is crucial in elderly patients with suspected gastrointestinal diverticulosis.
Keywords:
CT, computed tomographyCase reportIleal diverticulitisJID, Jejunoileal DiverticulosisJejunoileal diverticulosisMR, magnetic resonanceSmall bowel perforation

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