Rare Cause of Left Upper Abdominal Pain.

Inflamed diverticular disease of the small bowel is an uncommon cause of acute abdominal pain. Despite its low prevalence rate (0.3-2%), it is associated with a high mortality rate between 20-25% (Fisher and Fortin, 1977; Ferreira-Aparicio et al., 2012). This is due to complications including perforation, bleeding, and obstruction. This case report presents the diagnosis and management of Mr. X, a 70-year-old male with jejunal diverticulitis and a duodenal diverticulum. Mr. X has a background of type 2 diabetes mellitus and sigmoid diverticulosis, he presented with a three-day history of left upper quadrant pain radiating to the left iliac fossa. He was haemodynamically stable despite his elevated inflammatory markers (C-reactive protein 161 mg/l and neutrophils 13.3×109/l) and computerised tomography (CT) of the abdomen and pelvis showing jejunal diverticulitis and a duodenal diverticulum. Mr. X was successfully treated with intravenous antibiotics and analgesia and a follow up CT scan showed that the jejunal diverticulitis had resolved. Previous operative management of the discussed pathology has been reported, the current report is novel as the diagnosis was made early and the case managed conservatively.

Small Bowel Diverticulitis: An Unusual Cause of Abdominal Pain.

Teaching point: Small bowel diverticulitis, much less common than its colonic counterpart, is a diagnosis that must be considered in the presence of abdominal pain, especially in an elderly person.

Perforated Jejunal Diverticulum Mimicking Diverticulitis: A Case Report of Acute Abdominal Pain in an Elderly Patient.

Jejunal diverticulosis is a rare form of diverticulosis characterized by acquired pseudodiverticula in the small bowel. Although most cases are asymptomatic, the condition can present diagnostic challenges due to its atypical presentation. Complications such as perforation can lead to acute abdomen, significantly increasing morbidity and mortality. We report a rare case of perforated jejunal diverticulitis in an 84-year-old female with a known history of diverticular disease. The patient presented to the emergency department with worsening left lower quadrant abdominal pain. A computed tomography (CT) scan revealed a focus of air adjacent to the mesentery, indicative of bowel perforation. An urgent exploratory laparotomy was performed, which identified a 4-cm perforated jejunal diverticulum. The affected segment of the small bowel was resected, followed by primary side-to-side jejunal anastomosis. The patient was discharged home in stable condition following uneventful postoperative recovery. This case highlights the importance of including jejunal diverticulosis in the differential diagnosis of acute abdomen, particularly in elderly patients with a history of diverticular disease. Due to the nonspecific presentation, prompt imaging is crucial for diagnosis. Surgical intervention is often necessary in cases of perforation. Increased clinical awareness of this rare condition may help reduce diagnostic delays and improve patient outcomes.

Complete resolution of perforated jejunal diverticulitis after nonoperative management.

The authors report a case of perforated jejunal diverticulitis that was managed nonoperatively in a 60-year-old man. Nonoperative management of perforated jejunal diverticulitis is uncommon but possible, and necessitates close follow up to ensure complete resolution.

Left side jejunal diverticulitis: US and CT imaging findings.

Small bowel jejunoileal diverticulosis is an uncommon and usually asymptomatic condition. Complications may occur such as acute diverticulitis including infection or perforation, bleeding, small bowel obstruction and volvulus. Herein we report a case of a 76 years-old woman with acute left side abdominal pain and tenderness. A clinical suspected diagnosis of colonic diverticulitis was formulated. She underwent Ultrasound that revealed a collapsed small bowel loop with a large sac-like out-pouching lesion with mixed content (fluid and pockets of air) associated to hyperechogenicity of perilesional fat. Because of the atypical US findings, the patient underwent abdominopelvic CT that confirmed that the large sac-like out-pouching was a jejunal inflamed diverticulum. The patient underwent emergency surgery. Radiologist should be aware of imaging findings of jejunoileal diverticulitis in order to achieve a prompt diagnosis.

Isolated Perforation of Multiple Jejunal Diverticulae: A Very Rare Cause of Acute Abdomen.

Isolated jejunal diverticular (JD) perforation is extremely rare; it usually presents as a diagnostic dilemma and is often discovered incidentally on laparotomy. Most of these perforations are single. Literature has revealed only one case of multiple small bowel diverticular perforations. We report the first case of simultaneous perforation of four jejunal diverticulae in an 85-year-old male. Small bowel resection and primary anastomosis were performed. The patient had an uneventful post-operative recovery. This case highlights the importance of prompt diagnosis and timely management to reduce the morbidity and mortality of these patients. It should be included in the differential diagnosis in all elderly patients presenting with acute abdomen.

Perforated Jejunal Diverticulitis: Surgical and Antibiotic Management.

Small bowel diverticulitis occurs at a rate of 0.06% to 1.3%, mainly in individuals over 50, peaking between ages 60 and 70. Duodenal diverticula are the most common (79% of cases), followed by jejunal or ileal diverticula (18%), and diverticula in all segments combined (3%). This condition typically presents with sporadic abdominal pain and vague gastrointestinal symptoms, making diagnosis difficult. We report an 80-year-old male who presented to the emergency department with sudden, left-sided abdominal pain and nausea due to perforated jejunal diverticulitis. Despite undergoing side-to-side jejunojejunostomy and incidental appendectomy, the patient rapidly declined and expired 45 hours post-operation due to septic shock. This case highlights the scarcity of literature on jejunal diverticulitis and its treatment guidelines.

Complicated jejunal diverticulitis with small bowel obstruction due to enterolith: A case report.

INTRODUCTION AND IMPORTANCE: Small bowel diverticular disease (DD) is encountered and managed much less frequently than colonic DD, leading to a significantly less developed body of evidence for managing small bowel diverticulum and its associated complications. CASE PRESENTATION: This case report discusses a rare occurrence of simultaneous perforated jejunal diverticulitis and mechanical small bowel obstruction (SBO) due to a migrating diverticular enterolith. The patient's condition was ultimately managed operatively through laparoscopically assisted small bowel resection. CLINICAL DISCUSSION: A review of the literature reveals only eight reported cases of jejunal diverticulitis with simultaneous enterolith obstruction. All cases were managed operatively, with approaches including small bowel resection encompassing both pathologies, milking the enterolith back to the diverticulitis site and resecting en bloc to avoid extensive resection, or enterotomy and enterolith retrieval. CONCLUSION: The prevalence of small bowel diverticular disease is increasing, and as a result, clinicians may encounter more complications associated with this condition in the future. This case highlights the importance of considering alternate complications of small bowel DD.

Jejunal diverticulitis as a rare cause of abdominal pain: a case report.

Jejunal diverticulitis is an uncommon and underdiagnosed condition. Due to the rarity of This disease, diagnosis is often difficult and delayed. Medical treatment is usually sufficient for jejunal diverticulitis without peritonitis. Surgery is required in case of generalized peritonitis or voluminous abscess complicating diverticulitis. We report the case of a 76-year-old woman who suffered from recent abdominal pain. Diagnosis of uncomplicated jejunal diverticulitis was based on computed tomography (CT) scan. The evolution was favorable after antibiotic treatment. Jejunal diverticulitis have to be evoked among the differential diagnosis of patients with abdominal pain especially in the elderly and it is important for clinicians and radiologists to have awareness about this disease.

Complicated jejunal diverticulitis: A case report and review of literature.

Jejunal diverticulitis is an uncommon pathology wherein a delay in diagnosis can lead to significant morbidity and mortality. We report a case of such diverticula requiring operative management, after patient failed non-operative management, likely due to advanced jejunal inflammation from a delay in diagnosis and subsequent management.

Unexpected diagnosis of jejunal perforation after robot-assisted radical prostatectomy.

We report a rare case of perforated jejunal diverticulitis after an unrelated surgery. A 60-year-old male presented with severe abdominal pain one day after robot-assisted radical prostatectomy. This was diagnosed as perforated jejunal diverticulitis and managed via immediate partial jejunal resection. Key points are as follows. First, surgery may have indirect impacts on diverticulitis perforation because of postoperative intestinal hypomobility and immunosuppression. Second, the diagnosis becomes harder when the perforation occurs after surgery because postoperative laboratory and imaging findings are similar to those after jejunum perforation. Hence, aggressive diagnostic evaluation and immediate treatment are crucial for improving prognosis.

Perforated Jejunal Diverticulitis: a rare cause of acute abdominal pain.

It is imperative for surgeons to have a heightened awareness of complications of jejunal diverticular disease so that they can act quickly and contribute to a successful clinical outcome for their patients.

Isolated perforated jejunal diverticulitis: a case report.

Jejunal diverticulosis is a rare phenomenon often identified either incidentally on imaging or intra-operatively. Complications of jejunal diverticulosis are associated with high rates of mortality. For this reason, it remains important that this pathology is considered amongst differentials for an acute abdomen. A 78-year old gentleman presented with a short history of generalized lower abdominal pain. Computer tomography scan revealed a large inflammatory abscess relating to a perforated jejunal diverticulum. The patient was taken to theatre where he underwent small bowel resection with primary anastomosis. Early cross sectional imaging is vital to allow early diagnosis and prompt management of this pathology. Small bowel resection with primary anastomosis was associated with an excellent clinical outcome.

Surgically Managed Perforated Jejunal Diverticulitis.

A 71-year-old male with a past medical history significant for chronic constipation presented to the emergency department for acute onset of severe abdominal pain. On presentation, the patient appeared to be in distress, exemplifying signs of peritonitis despite vital signs being grossly benign. CT scan established the diagnosis of a perforated jejunal diverticulitis. Initially, the patient was managed conservatively with IV fluids, antibiotics, and pain control medications. Diagnostic imaging in tandem with the patient's failure to improve incited surgical intervention with a jejunal resection and establishment of a primary anastomosis. This case illustrates additional differential diagnoses necessary for consideration in an elderly patient presenting with an acute abdomen.

Acute Abdomen in a 91-Year-Old Male due to Perforated Jejunal Diverticulitis.

Non-Meckel small intestine diverticular disease is a rare and mostly asymptomatic condition. However, rare cases of acute and emergent complications bear a high mortality rate. We report a case of a 91-year-old male that presented with an acute abdomen due to perforated jejunal diverticulitis. A review of the literature and key points of the condition are depicted. Although jejunal diverticulosis is rare, it must be considered in the differential diagnosis, especially in the elderly with signs of ambiguous abdominal pain and peritonitis.

Perforated jejunal diverticulitis: a rare but important differential in the acute abdomen.

BACKGROUND: Diverticulosis of the small bowel is rare and, in most cases, discovered incidentally. However, diverticulitis and other complications are important to consider in the differential of an acute abdomen, especially in the elderly population. CASE PRESENTATION: The patient was a 59-year-old female who presented with acute lower abdominal pain progressing to peritonitis. Computed tomography scan showed a large inflamed and perforated diverticulum on the mesenteric side of the jejunum. Exploratory laparotomy revealed a dilated proximal jejunum with a 5-cm inflamed and perforated mesenteric diverticulum. A small bowel resection with primary anastomosis was performed. CONCLUSIONS: Jejunal diverticulitis remains a diagnostic challenge. Although uncommon, owing to its high mortality rate, it is an important clinical entity to consider and requires timely management.

Diverticulitis aguda yeyunal: serie de casos / Acute jejunal diverticulitis: a case series

Diverticula at the jejuno-ileum are rare. They correspond mostly to pseudo diverticula and usually go unnoticed. Among symptomatic patients the clinical presentation is heterogeneous. We present 3 cases of it most frequent complication: acute jejunal diverticulitis

La presencia de divertículos a nivel de yeyuno-íleon es infrecuente. Ellos corresponden mayormente a pseudo divertículos y suelen pasar desapercibidos. Entre los casos sintomáticos, la presentación clínica es heterogénea. Presentamos 3 casos de diverticulitis aguda yeyunal que es la complicación más frecuente.

Small Bowel Obstruction Due to Enterolith in a Patient with Diffuse Jejuno-Ileal Diverticulosis.

We report an unusual case of small bowel obstruction caused by a large enterolith released from small bowel diverticulitis in a 81-year-old patient with occult massive Diffuse Jejuno-Ileal Diverticulosis (DJID). DJID is a rare condition whose symptoms are usually absent or non-specific. In most cases, the diagnosis of DJID is incidentally made or consecutive to secondary complications comprising obstruction, haemorrhage, diverticulitis and perforation. We shortly review the clinical and imaging features and complications of DJID.

One of the Rare Causes of Acute Abdomen Leading to Subileus: Jejunal Diverticulitis.

BACKGROUND: Jejunal diverticulitis is one of the rare causes of acute abdomen generally seen in the elderly. Jejunal diverticulosis was defined as the herniation of the mucosa and the submucosa from the inside of the muscular layer of the bowel wall on the mesenteric side of the intestine. CASE REPORT: We presented the intraoperative and pathological findings of a 69-year-old male patient who had presented with complaints about abdominal pain, nausea, and vomiting and been operated upon due to subileus and peritonitis induced by large-sized jejunal diverticulitis, along with his computed tomography (CT) findings. CONCLUSION: Jejunal diverticulitis is uncommon and may be a disease which might be difficult to diagnose when it develops on the basis of the large-sized diverticula resembling intestinal ansae. To the best of our knowledge, the computed tomography and intraoperative findings of a case in which partial resection is applied to the jejunum due to subileus have not been previously presented in the literature.