Laparoscopic management for spontaneous jejunal perforation caused by nonspecific ulcer: A case report
Tatsuma Sakaguchi1, Katsuji Tokuhara1, Kazuyoshi Nakatani1
1Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan.
Introduction:
Nonspecific small bowel ulcers are rare and there have been limited reports. We applied laparoscopic surgery successfully for the perforation caused by this disease of jejunum.
Presentation Of Case:
A 70-year-old man visited to our hospital with complaint of abdominal pain and fever. He was diagnosed abdominal peritonitis with findings of intraperitoneal gas and fluid. Emergency laparoscopic surgery was performed. A perforation 5mm in diameter was recognized in jejunum opposite side of mesentery. Partial resection of jejunum with end-to-end anastomosis and peritoneal lavage were performed. Pathologically, an ulcer was recognized around the blowout perforation without specific inflammation. He was discharged uneventfully 12days after surgery.
Conclusion:
Laparoscopic surgery has diagnostic and therapeutic advantages because of its lower invasion with a good operation view, and in case of the small bowel, it is easy to shift extra-corporeal maneuver.
Insights
Laparoscopic surgery successfully treated a rare jejunal perforation from a nonspecific small bowel ulcer. This minimally invasive approach offers diagnostic and therapeutic benefits for such conditions.
Area of Science:
- Gastroenterology
- Surgical Innovation
Background:
- Nonspecific small bowel ulcers are uncommon, with limited case reports.
- Perforation of the jejunum due to these ulcers presents a diagnostic and surgical challenge.
Purpose of the Study:
- To report a successful laparoscopic management of a jejunal perforation caused by a nonspecific small bowel ulcer.
- To highlight the advantages of minimally invasive surgery in treating rare gastrointestinal emergencies.
Main Methods:
- A 70-year-old male presented with symptoms of abdominal peritonitis.
- Emergency laparoscopic surgery revealed a 5mm jejunal perforation.
- Surgical procedure included partial jejunal resection, end-to-end anastomosis, and peritoneal lavage.
Main Results:
- Pathological examination confirmed a nonspecific ulcer around the perforation site.
- The patient recovered well and was discharged 12 days post-surgery.
- Laparoscopic surgery provided excellent visualization and minimal invasiveness.
Conclusions:
- Laparoscopic surgery is a viable and effective treatment for jejunal perforation secondary to nonspecific ulcers.
- The technique offers diagnostic and therapeutic advantages, including reduced invasiveness and improved surgical view.
- Laparoscopic approach facilitates manipulation for small bowel procedures.
