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Jejunal Diverticulitis: A Single-Center Experience and Proposed Management Algorithm.

Zi Qin Ng1, Mary Theophilus1, Suresh Navadgi1

  • 11Department of General Surgery, St John of God Midland Hospital, Midland, Western Australia, Australia.

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Summary
This summary is machine-generated.

Jejunal diverticulitis, a rare condition, often presents with non-specific symptoms leading to delayed diagnosis. A computed tomography (CT) scan is crucial for diagnosis, and a proposed algorithm can guide conservative management for select patients.

Keywords:
conservativediverticulitisjejunumresection

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Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Jejunal diverticulitis is a rare condition with non-specific symptoms, often leading to delayed diagnosis and significant mortality.
  • Accurate and timely diagnosis is challenging due to the vague clinical presentation.

Purpose of the Study:

  • To review the clinical experience with jejunal diverticulitis management.
  • To propose a management algorithm for jejunal diverticulitis.

Main Methods:

  • Retrospective review of eight jejunal diverticulitis cases from November 2015 to November 2018.
  • Data collection included demographics, clinical presentation, imaging, and management outcomes.
  • Computed tomography (CT) scans were utilized for diagnosis.

Main Results:

  • Eight patients (5 female, 3 male, median age 71) were identified.
  • All patients presented with abdominal pain; symptoms were otherwise variable.
  • CT scans revealed uncomplicated diverticulitis in three and localized perforation in five patients.
  • Five patients were initially managed conservatively; two required intervention for complications.
  • Three patients underwent emergency laparotomy due to sepsis or suspected foreign body.
  • No deaths occurred during the study period.

Conclusions:

  • Computed tomography (CT) is the primary diagnostic tool for jejunal diverticulitis.
  • A proposed management algorithm can assist in identifying suitable candidates for conservative treatment.
  • Early diagnosis and appropriate management are key to improving outcomes.