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Surgery for non-Meckel's small-bowel diverticular perforation: two case reports and a literature review

Naoki Matsuya1, Akifumi Kuwabara2, Nobuhiro Morioka2

  • 1Department of Surgery, Saiseikai Niigata Hospital, 280-7, Teraji, Niigata, Niigata, 950-1104, Japan. n_matsuya1003@icloud.com.

Surgical Case Reports
|October 8, 2024
PubMed
Abstract

Insights

Non-Meckel

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology

Background:

  • Small-intestinal diverticula, unlike colonic diverticula, can lead to severe, life-threatening complications.
  • Non-Meckel's small-bowel diverticular perforation is a rare but high-mortality event.
  • Optimal therapeutic management for this condition remains debated.

Purpose of the Study:

  • To present two cases of non-Meckel's small-bowel diverticular perforation.
  • To discuss the diagnostic and therapeutic challenges associated with this condition.

Main Methods:

  • Two case reports of patients with small-bowel diverticular perforation are presented.
  • Diagnostic imaging utilized included enhanced computed tomography (CT).
  • Treatment strategies involved both conservative management and emergency surgical intervention.

Main Results:

  • Both cases involved elderly patients presenting with abdominal pain and signs of perforation on CT.
  • Initial conservative management in one case was followed by emergency surgery due to worsening symptoms and evidence of extraintestinal gas.
  • Both patients ultimately underwent segmental resection of the perforated jejunum with anastomosis.

Conclusions:

  • Conservative treatment for small-bowel diverticular perforation may be considered for mild cases.
  • Surgical intervention, including segmental resection and anastomosis, is the definitive treatment and should not be delayed.
  • Documentation of residual diverticula is crucial to monitor for potential recurrence of diverticulosis.
Keywords:
Emergency surgeryMultiple small-intestinal diverticulaSmall intestinal perforation

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