Garteiz-Martínez D, Weber-Sánchez A, Jorge DL, Carbó-Romano R

Language: Spanish
References: 9
Page: 34-37
PDF size: 210.25 Kb.

ABSTRACT

Introduction: Among the rare causes of abdominal pain in elderly patients is small bowel diverticulosis. It can present with a great variety of digestive symptoms, from diarrhea, bleeding and malabsorption to intestinal obstruction, acute abdomen, and sepsis. Adequate diagnosis requires a high index of suspicion and is often achieved incidentally during surgical exploration. Clinical case: Eighty-year-old male with an acute abdomen in whom tomography showed multiple saculations throughout the gastrointestinal tract (from the duodenum to the colon), one of them with signs of perforation and abscess. Laparoscopic exploration confirmed the presence of a perforated jejunal diverticulum and small bowel resection with hand assisted anastomosis was performed. Postoperative course and follow up were uneventful. Conclusion: This case report exemplifies the clinical presentation, diagnostic criteria, and treatment options for this unusual cause of acute abdomen in elderly patients.

REFERENCES

1. Fintelmann F, Levine MS, Rubesin SE. Jejunal diverticulosis: findings on CT in twenty-eight patients. AJR Am J Roentgenol. 2008; 190: 1286-1290.

2. Serrano-González J, Artés-Caselles M, Román-García de León L, Plá-Sánchez P, Sánchez-Turrión V. Manejo de la diverticulitis yeyunal. Experiencia en nuestro centro. Cir Cir. 2018; 86: 148-151.

3. Horesh N, Klang E, Gravetz A, Nevo Y, Amiel I, Amitai MM et al. Jejunal diverticulitis. J Laparoendosc Adv Surg Tech A. 2016; 26: 596-599.

4. Dahl C, Crichton M, Jenkins J, Nucera R, Mahoney S, Marx W et al. Evidence for dietary fibre modification in the recovery and prevention of reoccurrence of acute, uncomplicated diverticulitis: a systematic literature review. Nutrients. 2018; 10: 137.

5. Fluxá D, Quera R. Enfermedad diverticular: mitos y realidades. Rev Med Chile. 2017; 145: 209-218.

6. Balcazar VCM, Ayola RBC, Ocampo CJM, Bejarano M. Perforación del yeyuno por enfermedad diverticular: una condición a considerar en ancianos. Rev Colomb Gastroenterol. 2019; 34: 202-206.

7. Ghrissi R, Harbi H, Elghali MA, Belhajkhlifa MH, Letaif MR. Jejunal diverticulosis: a rare cause of intestinal obstruction. J Surg Case Rep. 2016; 2: 1-3.

8. Spasojevic M, Naesgaard JM, Ignjatovic D. Perforated midgut diverticulitis: revisited. World J Gastroenterol. 2012; 18: 4714-4720.

9. Harbi H, Kardoun N, Fendri S, Dammak N, Toumi N, Guirat A et al. Jejunal diverticulitis. Review and treatment algorithm. Presse Med. 2017; 46: 1139-1143. doi: 10.1016/j.lpm.2017.08.009.