RETRACTED ARTICLE: Perforated isolated jejunal diverticula: a rare cause of acute abdomen
- PDF / 839,283 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 87 Downloads / 142 Views
CASE REPORT
Perforated isolated jejunal diverticula: a rare cause of acute abdomen Davinder Koli1 · Manu Vats2 · Harsh Vardhan Upreti3 Received: 25 March 2020 / Accepted: 23 May 2020 © Japanese Society of Gastroenterology 2020
Abstract Case report A 45-year-old female presented to the surgery emergency department with complaints of pain in the whole abdomen, vomiting and non-passage of flatus and stools for the past one day. Physical examination revealed tachycardia with a normal blood pressure. The abdomen showed diffuse tenderness and guarding and bowel sounds were absent. After appropriate fluid resuscitation, the patient underwent a non-contrast computed tomography, which showed intra-abdominal free air. She was then prepared for exploratory laparotomy. Intraoperatively, three jejunal diverticula were identified at the mesenteric side, with perforation of the distal two. Segmental resection of the jejunum, including three diverticula, with primary end-to-end anastomosis was performed. Histopathology report confirmed the diagnosis of jejunal diverticula. Conclusion Jejunal diverticula are extremely rare and are usually asymptomatic. However, such presentation warrants their inclusion under the differential diagnosis of acute abdomen, albeit lower down the order. Isolated jejunal diverticular perforation is a rare complication and may present as a surprise intraoperative finding to the operating surgeon. Keywords Jejunal diverticulosis · Perforation · Acute abdomen · Primary repair
Introduction Diverticular disease of the jejunum is a rare entity with an incidence of less than 1% amongst all diverticula occurring from the stomach till the recto-sigmoid region. Males are more commonly affected (58%) as compared to females (42%) according to a report [1]. Jejunal diverticula are usually located on the mesenteric border of the intestine. They have been shown to be present in 2% of small bowel enteroclysis studies and in 5% of post mortem studies [2, 3]. Jejunal diverticula usually co-exist with the diverticula of colon * Davinder Koli [email protected] Manu Vats [email protected] Harsh Vardhan Upreti [email protected] 1
Department of General Surgery, Maulana Azad Medical College and Lok Nayak Hospital, 9725/15 Katra Nanak Chand, Kishan Ganj, New Delhi, India
2
Department of General Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
3
Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
and therefore, isolated jejunal diverticula is a rare finding. They develop as a result of outpouching of mucosa and submucosa through the weakest part of the muscularis propria of the intestinal wall. Majority of jejunal diverticula are asymptomatic. However, when symptomatic, they present with non-specific complaints like diarrhoea, malabsorption, postprandial flatulence attributed to small intestinal bacterial overgrowth (SIBO). Very rarely complications, such as intestinal obstruction, perforation, haemorrhage or diverticulitis are the presenting fea
Data Loading...
