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Perforated jejunal diverticula- a rare cause of acute abdominal pain: a case report.

Akbari ME, Atqiaee K, Lotfollahzadeh S, Moghadam AN, Sobhiyeh MR - Gastroenterol Hepatol Bed Bench (2013)

Bottom Line: The day before admission he developed an abrupt exacerbation his symptoms with pain localized to periumbilical and left lower quadrant.Physical examination revealed left upper quadrant fullness.An emergency laparotomy was carried out.

View Article: PubMed Central - PubMed

Affiliation: Cancer Research Centre, Shahid Beheshti University of Medical Sciences, Shohadae-Tajrish Hospital, Tehran, Iran.

ABSTRACT
Jejunal diverticula have a prevalence of approximately 1% in the general population. Perforation of jejunal diverticulum is a rare. Clinically this diagnosis may be easily confused with other causes of an acute abdomen. In the article, we discuss a 74-year-old man with a 2-day history of constipation and left-sided abdominal pain. The day before admission he developed an abrupt exacerbation his symptoms with pain localized to periumbilical and left lower quadrant. An abdominal computed tomography scan revealed soft tissue stranding within the left upper quadrant, bilateral plural effusions , larger on the left, an opacity with the right and left pulmonary lobes and polypoid lesion with in stomach. Physical examination revealed left upper quadrant fullness. An emergency laparotomy was carried out. This revealed multiple jejunal diverticula, one of which had perforated 40 centimeters distal to the ligament of Treitz.

No MeSH data available.


Related in: MedlinePlus

The perforated diverticulum in distal to the ligament of Treitz
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Figure 0001: The perforated diverticulum in distal to the ligament of Treitz

Mentions: On examination he was clinically dehydrated. Vital signs were normal. His abdomen was tender in the left upper quadrant with localized rebound tenderness. Bowel sounds were present. Routine laboratory investigations were normal. His chest x ray was normal and abdominal x-ray showed prominent but non-dilated small bowel loops. Intravenous fluids and broad spectrum antibiotics were commenced. At emergency laparotomy there were multiple jejunal diverticula, one of which had perforated. Adhesions between the jejunum to the omentum were gently dissected. The jejunum was examined and multiple diverticula, from 10 to 70 cm - distal to the ligament of Treitz. The diverticulum sizes varied from 1.5 cm to 3 cm. The perforated diverticulum was located 40cm distal to the ligament of Treitz (Fig 1). The rest of the gastrointestinal tract, including the stomach, gallbladder and remainder of the small intestine, appeared normal. A 20cm segmental resection of the jejunum was carried out. The patient was discharged a week later.


Perforated jejunal diverticula- a rare cause of acute abdominal pain: a case report.

Akbari ME, Atqiaee K, Lotfollahzadeh S, Moghadam AN, Sobhiyeh MR - Gastroenterol Hepatol Bed Bench (2013)

The perforated diverticulum in distal to the ligament of Treitz
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4017513&req=5

Figure 0001: The perforated diverticulum in distal to the ligament of Treitz
Mentions: On examination he was clinically dehydrated. Vital signs were normal. His abdomen was tender in the left upper quadrant with localized rebound tenderness. Bowel sounds were present. Routine laboratory investigations were normal. His chest x ray was normal and abdominal x-ray showed prominent but non-dilated small bowel loops. Intravenous fluids and broad spectrum antibiotics were commenced. At emergency laparotomy there were multiple jejunal diverticula, one of which had perforated. Adhesions between the jejunum to the omentum were gently dissected. The jejunum was examined and multiple diverticula, from 10 to 70 cm - distal to the ligament of Treitz. The diverticulum sizes varied from 1.5 cm to 3 cm. The perforated diverticulum was located 40cm distal to the ligament of Treitz (Fig 1). The rest of the gastrointestinal tract, including the stomach, gallbladder and remainder of the small intestine, appeared normal. A 20cm segmental resection of the jejunum was carried out. The patient was discharged a week later.

Bottom Line: The day before admission he developed an abrupt exacerbation his symptoms with pain localized to periumbilical and left lower quadrant.Physical examination revealed left upper quadrant fullness.An emergency laparotomy was carried out.

View Article: PubMed Central - PubMed

Affiliation: Cancer Research Centre, Shahid Beheshti University of Medical Sciences, Shohadae-Tajrish Hospital, Tehran, Iran.

ABSTRACT
Jejunal diverticula have a prevalence of approximately 1% in the general population. Perforation of jejunal diverticulum is a rare. Clinically this diagnosis may be easily confused with other causes of an acute abdomen. In the article, we discuss a 74-year-old man with a 2-day history of constipation and left-sided abdominal pain. The day before admission he developed an abrupt exacerbation his symptoms with pain localized to periumbilical and left lower quadrant. An abdominal computed tomography scan revealed soft tissue stranding within the left upper quadrant, bilateral plural effusions , larger on the left, an opacity with the right and left pulmonary lobes and polypoid lesion with in stomach. Physical examination revealed left upper quadrant fullness. An emergency laparotomy was carried out. This revealed multiple jejunal diverticula, one of which had perforated 40 centimeters distal to the ligament of Treitz.

No MeSH data available.


Related in: MedlinePlus