Abstract
Background: Jejunal diverticulosis and jejunal lipomatosis are uncommon conditions. Usually asymptomatic, they may cause severe complications in some cases. Intussusception is unusual in adults, but when diagnosed swiftly it can be treated surgically, usually with good outcome. Case presentation: We present a 60-year-old female patient with a history of chronic malnutrition and anemia, complaining of acute abdominal pain, vomiting and diarrhea. Contrast-enhanced abdominal computed tomography (CT) showed intussusception, multiple giant jejunal diverticula and multiple lipomas. The patient underwent urgent surgery, but radical treatment was not possible due to the extent of the diseases. One month later, another surgery was needed due to ileostomy obstruction caused by lipomas. The patient’s condition deteriorated due to malnutrition and concomitant metabolic disorders, which eventually led to her demise. Conclusions: Radical treatment is not always possible in an extensive jejunal disease. Prolonged malnutrition impairs postoperative healing, and therefore surgical or nutritional treatment should be considered in jejunal diverticulosis before the onset of severe complications requiring urgent surgical intervention.
Highlights
Jejunal diverticulosis is a rare condition affecting 0.2–4.5% of the population [1].Usually asymptomatic, it is found accidentally during radiological investigation
We hereby present a case of giant jejunal diverticulosis with concomitant multiple lipomas, which caused intussusception and eventually led to the patient’s death
The polyps were surgically removed through the ileostomy; malnutrition caused by diverticulosis and chronic kidney disease (CKD) exacerbation led to multiorgan failure and eventually to the patient’s death
Summary
Jejunal diverticulosis is a rare condition affecting 0.2–4.5% of the population [1]. Asymptomatic, it is found accidentally during radiological investigation. Intussusception is a rare cause of abdominal pain in adults, best diagnosed in a CT [3]. We hereby present a case of giant jejunal diverticulosis with concomitant multiple lipomas, which caused intussusception and eventually led to the patient’s death. This highlights the challenge met by a surgeon when a rare and extensive small intestine disease requires urgent surgery in a malnourished patient
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