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Vol. 84. Issue 4.
Pages 515-516 (October - December 2019)
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Vol. 84. Issue 4.
Pages 515-516 (October - December 2019)
Clinical image in Gastroenterology
DOI: 10.1016/j.rgmxen.2019.07.002
Open Access
Regarding a case of perforated jejunal diverticulitis
Diverticulitis yeyunal perforada, a propósito de un caso
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L. Vega
Corresponding author
lvegaro@csa.cat

Corresponding autor: Avenida de Cataluña 11, 08700 Igualada, Barcelona, Spain. Tel.: 0034-652727153.
, D. Carmona, J. Camps
Servicio de Cirugía General y Digestiva, Consorcio Sanitario de la Anoia, Hospital de Igualada, Igualada, Barcelona, Spain
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An 88-year-old woman sought medical attention for mesogastric pain of 2-day progression associated with vomiting and fever. Physical examination revealed pain upon palpation with guarding and positive decompression. Laboratory test results showed leukocytosis and neutrophilia. An abdominal computed tomography scan identified jejunal diverticula, inflammatory changes in the mesentery, and pneumoperitoneum (Fig. 1). A midline laparotomy was performed, revealing multiple diverticula in the proximal jejunum, 40 cm from the ligament of Treitz, one of which was perforated at the antimesenteric edge (Fig. 2). The compromised area was resected with a mechanical laterolateral anastomosis. The patient’s postoperative period was favorable, and she was released on day 8. The histopathologic report stated perforated jejunal diverticulitis. Unlike colonic diverticular disease, small bowel diverticulitis is a rare pathology. Its incidence is approximately 1% and 70% of the cases are asymptomatic. Urgent surgical intervention is usually required in 10–20% of the patients. The inflammatory process can be primary, secondary to the action of a foreign body, or due to blunt abdominal trauma. Treatment consists of resection of the area of the affected intestine and anastomosis.

Figure 1.

At physical examination there was pain upon palpation, with guarding and positive decompression. Laboratory test results revealed leukocytosis and neutrophilia. The abdominal computed tomography scan revealed jejunal diverticula, inflammatory changes in the mesentery, and pneumoperitoneum.

(0.23MB).
Figure 2.

Midline laparotomy was performed, identifying multiple diverticula in the proximal jejunum, 40 cm from the ligament of Treitz, one of which was perforated at the antimesenteric edge.

(0.07MB).
Ethical disclosures

Protection of human and animal subjects. The authors declare that no experiments were performed on humans or animals for this study.

Confidentiality of data. The authors declare that they have followed the protocols of their work center on the publication of patient data, with absolute patient anonymity.

Right to privacy and informed consent. The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.

Financial disclosure

No financial support was received in relation to this article.

Conflict of interest

The authors declare that there is no conflict of interest.

Please cite this article as: Vega L, Carmona D, Camps J, Diverticulitis yeyunal perforada, a propósito de un caso. Revista de Gastroenterología de México. 2019;84:515–516.

Copyright © 2019. Asociación Mexicana de Gastroenterología
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