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Perforated jejunal diverticula

K E Koger1, C H Shatney, F M Dirbas

  • 1Department of Surgery, Stanford University Medical Center, California, USA.

The American Surgeon
|January 1, 1996
PubMed
Summary
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Jejunal diverticular (JD) perforation, a rare cause of abdominal pain in older adults, requires prompt surgical intervention. Delayed treatment increases the risk of severe contamination and sepsis, highlighting the importance of early diagnosis and resection.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Geriatric Medicine

Background:

  • Jejunal diverticular perforation is an infrequent cause of acute abdominal pain, particularly in the elderly population.
  • The condition often presents with non-specific symptoms, leading to delayed diagnosis and treatment.

Purpose of the Study:

  • To analyze the clinical presentation, management, and outcomes of patients with jejunal diverticular perforation.
  • To emphasize the importance of timely surgical intervention in improving patient prognosis.

Main Methods:

  • Retrospective review of 13 patients treated for jejunal diverticular perforation between 1971 and 1994.
  • Analysis of patient demographics, clinical symptoms, diagnostic methods, surgical interventions, and postoperative outcomes.

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Main Results:

  • Patients presented with sudden abdominal pain, nausea, vomiting, and leukocytosis.
  • Delayed surgical intervention correlated with increased peritoneal contamination and poorer outcomes.
  • Early surgery in 3 patients resulted in minimal contamination, while delayed surgery in 10 patients led to varied degrees of soilage and abscess formation in 5.
  • Two patients with delayed consultation and severe contamination died of sepsis.

Conclusions:

  • Jejunal diverticular perforation is an uncommon but critical condition in the elderly that is frequently overlooked.
  • Prompt surgical resection of the affected jejunal segment is crucial for successful management.
  • A history of jejunal diverticula should raise suspicion for perforation in elderly patients presenting with acute abdominal pain.