Multiple simultaneous small intestinal diverticular penetrations
Masahide Miyata1, Hirofumi Tazawa1, Akihisa Saito2
1Department of Surgery, NHO Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama, Kure 737-0023, Hiroshima, Japan.
Abstract:
Jejunal diverticulosis is a rare condition. Here, we report a rare case of multiple simultaneous small intestinal diverticular penetrations. An 82-year-old man was admitted with a chief complaint of slurred speech. The patient had fever and elevated C-reactive protein (CRP) levels. Incidentally, two abscesses with increased density in the surrounding fatty tissue were identified using computed tomography. An emergency surgery was performed. A series of diverticula were found on the mesenteric side, spanning the area of abscess formation. We performed a partial resection of the jejunum, including abscess formation, and functional end-to-end anastomosis. Pathological examination indicated two instances of acute pyogenic diverticulitis with penetration. No cases of multiple simultaneous diverticular penetrations have been reported. However two previous reports described that of perforations. Most reports involved partial resection of the jejunum, including the perforated or penetrated site. Here, we report a rare case of multiple simultaneous small intestinal diverticulum penetrations.
Insights
This report details a rare case of multiple simultaneous jejunal diverticular penetrations in an 82-year-old male. This condition, marked by abscesses and inflammation, required surgical intervention and jejunal resection.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Jejunal diverticulosis is an uncommon condition.
- Diverticular penetrations are rare complications of jejunal diverticulosis.
Observation:
- An 82-year-old male presented with fever and elevated C-reactive protein (CRP).
- Computed tomography revealed two abscesses in the small intestine.
- Emergency surgery identified multiple jejunal diverticula with abscess formation.
Findings:
- Pathological examination confirmed acute pyogenic diverticulitis with penetration at two sites.
- This represents the first reported case of multiple simultaneous small intestinal diverticular penetrations.
- Surgical management involved partial jejunal resection and anastomosis.
Implications:
- Highlights the potential for multiple simultaneous penetrations in jejunal diverticulosis.
- Emphasizes the importance of surgical intervention for complicated jejunal diverticulitis.
- Contributes to the limited literature on rare small intestinal diverticular complications.
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