Jejunal Diverticulitis Research Articles

Jejunal diverticulitis: an unusual cause of an intra-abdominal abscess - coronal Computed Tomography reconstruction can aid the diagnosis

Jejunal diverticulitis is a rare condition that can present with an acute abdomen and be referred for imaging. We present the case of an elderly patient who at CT was diagnosed with an intra-abdominal abscess involving both jejunum and transverse colon. However, the underlying eitiology was not initially clear until small bowel barium follow-through.Pertinent points regarding CT findings in jejunal diverticulitis are discussed, and practical recommendations in small bowel diverticulum recognition and diagnosis are made.

Feasibility of Single-Balloon Enteroscopy for Evaluation of the Small Bowel

Purpose: The single-balloon enteroscope (SBE) for investigation of the small bowel was introduced very recently. The handling of the device might be simplified by omitting the balloon on the top of the endoscope compared to the double-ballon enteroscope (DBE). In this prospective study we have investigated the handling and the diagnostic and therapeutic opportunities in the small bowel as well as the complications of the SBE. Methods: An enteroscopy was performed in 38 patients with (mean age 62 y, 25 female, 13 male) using the singe-balloon device (SIF-Q180, Olympus, Germany). Overall 53 investigations were performed (41 via oral route, 12 via anal route) in combined midazolam/propofol sedation under fluoroscopic control. Indications were occult GI-bleeding after previous endoscopic evaluation of the upper and lower GI tract (N = 18), IBD (N = 13), suspected malignant disease (N = 3), unclear malabsorption syndrome (N = 4). The push and pull-back of the endoscope is comparable to the DBE. Instead of insufflation of the second balloon at the top of the endoscope, the endoscope is in a stable position fixed by bending behind a fold during the pull-back of the endoscope and the overtube. The deepest point during SBE was marked by submucosal ink injection. Results: Overall a diagnostic and/or therapeutic gain was reached in 22 patients (58%) by SBE. Angiodysplasias were the most common findings, treated immediately with APC. Rare diagnosis like jejunal diverticulitis and primary adenocarcinoma of the jejunum were diagnosed. We have seen cases with segmental inflammation of the jejunum, lymphangiectasia and one pneumatosis. In one case the diagnosis of celiac disease was made on biopsies from jejunum with normal findings in the duodenum. Intubation of the ileum is sometimes difficult, we failed in 3 patients. The mean investigation time was 68 min, we used in the mean 2.5 mg midazolam and 460 mg Propofol (=7 mg/min). In 7 patients significant increase of amylase/lipase was observed, none of them suffered from abdominal pain. Superficial mucosal lacerations have been observed in 4 cases. The preparation time before the investigation is about 15 min less compared to DBE because there is no installation of a second balloon on the top of the endoscope. Conclusion: The single-balloon enteroscope is a highly sufficient device for investigations of the small bowel. Advantages are due to the easier handling and resulting in a reduced need of man power. The diagnostic possibilities should be equal compared to the DBE.

Diagnosis of Jejunal Diverticulitis by Oral Single-Balloon Enteroscopy

Diagnosis of Jejunal Diverticulitis by Oral Single-Balloon Enteroscopy

Jejunal diverticulitis

A case of perforated jejunal diverticulitis in a 44-yr-old man is described and the literature is reviewed. Jejunal diverticulosis occurs in 0.07% to 2% of the population. Enteroclysis is the best diagnostic test. Diverticulitis with perforation is rare and is associated with high mortality. Treatment is surgical resection of the involved segment. Other complications are bacterial overgrowth, obstruction, and acute hemorrhage. Several theories to explain the physiopathogenesis of the diverticula formation may relate to manometric or histological abnormalities of the small bowel.

Une cause rare d’abdomen aigu : la diverticulite jéjunale

Jejunal diverticulitis is a rare cause of acute abdomen and is diagnosed preoperatively only infrequently. A 34-year-old man presented with a history of increasing nonradiating epigastric and left upper abdominal pain and with fever, constipation, nausea and vomiting. His white blood cell count was 18,300/mm(3). Liver function tests and pancreatic enzymes were in the normal range. An abdominal CT scan showed jejunal diverticulitis and bubble gases in the extraluminal space. Perineal irritation led to an emergency midline laparotomy, which discovered diverticulitis of the jejunum at 50 cm from the Treitz ligament, resected the jejunum and performed end-to-end anastomosis. The pathology examination confirmed the diagnosis. Because the clinical presentation of complicated jejunal diverticulitis is generally nonspecific, diagnosis is very difficult. CT scan is a reliable diagnostic tool. Surgery, including resection of the diseased bowel portion with direct anastomosis, is the treatment generally reported for small intestinal diverticulitis complicated by hemorrhage, obstruction, or perforation. Some authors report using medical treatment only for diverticulitis.

Acute ulcerative jejunal diverticulitis: Case report of an uncommon entity

Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. Its reported incidence varies from 0.05% to 6%. Although there is no consensus on the management of asymptomatic jejunal diverticular disease, some complications are potentially life threatening and require early surgical treatment. We report a case of an 88-year-old man investigated for acute abdominal pain with a high biological inflammatory syndrome. Inflammation of multiple giant jejunal diverticulum was discovered at abdominal computed tomography (CT). As a result of the clinical and biological signs of early peritonitis, an emergency surgical exploration was performed. The first jejunal loop showed clear signs of jejunal diverticulitis. Primary segmental jejunum resection with end-to-end anastomosis was performed. Histopathology report confirmed an ulcerative jejunal diverticulitis with imminent perforation and acute local peritonitis. The patient made an excellent rapid postoperative recovery. Jejunal diverticulum is rare but may cause serious complications. It should be considered a possible etiology of acute abdomen, especially in elderly patients with unusual symptomatology. Abdominal CT is the diagnostic tool of choice. The best treatment is emergency surgical management.

Medical Management of Jejunal Diverticulitis

Medical Management of Jejunal Diverticulitis

Perforated jejunal diverticulitis

Perforated jejunal diverticulitis

Diverticulitis of the Small Bowel

In contrast to diverticulosis of the large bowel, diverticular disease of the small bowel is rare. This small bowel disease is predominantly localized to the duodenum. Jejunal and ileal diverticula are rare and occur in the majority of patients without clinical impact. Less than 10% of patients develop serious complications, including obstruction, hemorrhage, perforation and penetration. Here, we present 4 patients with jejunal diverticulitis. Three of these patients experienced perforation.

Complicated small-bowel diverticulosis: A case report and review of the literature

While jejunoileal diverticula are rare and often asymptomatic, they may lead to chronic non-specific or acute symptoms. The large majority of complications present with an acute abdomen similar to appendicitis, cholecystitis or colonic diverticulitis but they also may appear with atypical symptoms. As a result, diagnosis of complicated jejunoileal diverticulosis can be quite difficult, and may solely depend on the result of surgical exploration. In the absence of contra-indications, diagnostic laparoscopy has the benefit of thorough examination of the abdominal contents and helps to reach an absolute diagnosis. Surgical resection of the involved small-bowel segment with primary anastomosis is the preferred treatment in patients with symptomatic complicated jejunoileal diverticular disease. An atypical presentation of complicated jejunal diverticulitis in conjunction with sigmoid diverticulitis diagnosed with laparoscopy and treated with surgical resection is presented.

CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management

To describe the imaging findings of jejunal diverticulitis as depicted at contrast-enhanced computed tomography (CT) and review the differential diagnosis and clinical management. CT and pathology databases were searched for the diagnosis of jejunal diverticulitis. Three cases were identified and the imaging and clinical findings correlated. Jejunal diverticulitis presents as a focal inflammatory mass involving the proximal small bowel. A trial of medical management with antibiotics may be attempted. Surgical resection may be required if medical management is unsuccessful. The imaging findings at MDCT may allow a specific diagnosis of jejunal diverticulitis to be considered and may affect the clinical management of the patient.

Jejunal diverticulitis in an elderly female. Manifestations and treatment of a rare entity

A case of multiple jejunal diverticulae with perforation is described. Jejunal diverticulae are rare in the general population with occurrence of .5-1%. Most cases are asymptomatic and require no treatment. Typically jejunal diverticulae become acutely symptomatic due to obstruction, hemorrhage, diverticulits and partial bowel obstruction. Our patient presented with segmental jejunal diverticulitis that was amenable to resection and primary anastamosis. A case history and typical course of treatment is described.

Radiologic Findings of Perforated Jejunal Diverticulitis: A Case Report

We report a case of perforated jejunal diverticulitis in a 68-year-old man with iatrogenic Cushing’s syndrome. The patient presented with right upper abdominal pain. Ultrasonography showed a hypoechoic structure connected to a small bowel loop, and subsequent CT examination showed multiple diverticula in proximal jejunal loops with free air trapped within the mesenteric leaf. Segmental resection of the jejunal loop confirmed jejunal diverticulitis with perforation.

Abdominal Wall Abscess Associated with Perforated Jejunal Diverticulitis: Report of a Case

We report a case of abdominal wall abscess caused by diverticulitis of the jejunum penetrating through the abdominal wall. A 53-year-old Japanese woman visited a local hospital complaining of abdominal pain and a mass in the left lower abdomen. An abdominal computed tomography scan showed a tumor with isodensity in the left lower abdominal wall. Magnetic resonance imaging showed a mass in the abdominal wall with isointensity in the T1-intensified image and high intensity in the T2-intensified images. The mass was heterogeneous inside and protruded partially toward the intraperitoneal cavity. Ultrasound examination showed a heteroechoic mass extending into the intraperitoneal cavity. Laparotomy revealed a tumor in the abdominal wall with a fistulous tract extending to the jejunum. We resected the abdominal wall tumor with partial resection of the small intestine. The resected specimen contained a tumor with a fistulous tract passing through the abdominal wall. Histological examination revealed remarkable infiltration of neutrophils and a bacterial mass in the abdominal wall tumor, with a fistulous tract connected to the area adjacent to the mesenteric border of the jejunum. These findings suggested that diverticulitis of the jejunum had penetrated through the abdominal wall, leading to the formation of an abscess. We report this case to highlight the need for complete gastrointestinal evaluation with gastrointestinal barium studies and imaging analysis to examine extension of intra-abdominal lesions in patients with an unexplained abdominal wall abscess.

A Case of Jejunal Diverticulitis with Perforation Combined with Intussusception Caused by Inflammatory Fibroid Polyp

Diverticulosis of the small intestine is a rare entity, compared with that of duodenum or colon, and is found in only 1% of autopsied patients. The main complications are diverticulitis with or without a perforation, obstruction and hemorrhage, which are associated with a high mortality. Intussusception is primarily a disease of childhood; with only 5 to 10% of cases occurring in adults. In contrast to childhood intussusception, 90% of adult intussusception cases are had an associated pathologic processes. An inflammatory fibroid polyp is an uncommonly localized non-neoplastic lesion of the gastrointestinal tract. It occurs most often in the stomach and secondly in the ileum. It rarely occurs in other organs such as the colon, jejunum, duodenum and esophagus. We report a case of jejunal diverticulitis with a perforation combined with intussusception caused by an inflammatory fibroid polyp. A 78-year-old female presented with abdominal pain, fever and chill. Contrast CT scan showed intussusception of the ileum. The patient was treated with a small bowel segmental resection. After surgery, the specimen showed jejunal diverticulitis with perforation.

Jejunal diverticulitis with localized perforation and intramesenteric abscess

We report a rare case of a 69-yr-old white man with jejunal diverticulitis with localized perforation and intramesenteric abscess formation. This entity is often overlooked as a cause of acute abdominal pain in the elderly. Although the clinical diagnosis is difficult, a high index of suspicion should warrant a computed tomography scan or enteroclysis.

Perforated Solitary Jejunal Diverticulum

We report a case of perforated solitary jejunal diverticulum in an 80-year-old woman. Jejunal diverticulosis occurs in 0.07% to 2.0% of the population. Jejunal diverticulitis with perforation is rare and is associated with high mortality. Treatment is surgical resection of the involved segment. Several theories to explain the pathogenesis of jejunal diverticula may relate to manometric or histologic abnormalities of the small bowel.

Diverticulitis of the jejunum: Clinical and radiological features

This article describes three cases of jejunal diverticulitis in elderly women, who had presented with pain and tenderness in the periumbilical region or the left side of the abdomen, low-grade fever, anemia, and weight loss. The findings were initially attributed to possible inflammatory or neoplastic lesions of the colon. However, gastrointestinal barium studies and computed tomography (CT) of the abdomen proved crucial in establishing the preoperative diagnosis of jejunal diverticulitis and its associated abscess in the adjacent mesentery or abdominal wall. The clinical and radiological manifestations of this uncommon entity are herein presented along with a brief review of the pertinent literature.

Perforated jejunal diverticulitis

International Journal of Clinical PracticeVolume 43, Issue 4 p. 165-166 Case Report Perforated jejunal diverticulitis D Scrimgeour FRCS, Corresponding Author D Scrimgeour FRCS Surgical Registrar n/[email protected] Department of Surgery, Stracathro Hospital, Brechin, AngusAddress correspondence to Mr D Scrimgeour, Surgical Registrar, Stracathro Hospital, Brechin, Angus DD9 7QA.Search for more papers by this authorA D Irving MRCP, FRCS, A D Irving MRCP, FRCS Consultant Surgeon Department of Surgery, Stracathro Hospital, Brechin, AngusSearch for more papers by this author D Scrimgeour FRCS, Corresponding Author D Scrimgeour FRCS Surgical Registrar n/[email protected] Department of Surgery, Stracathro Hospital, Brechin, AngusAddress correspondence to Mr D Scrimgeour, Surgical Registrar, Stracathro Hospital, Brechin, Angus DD9 7QA.Search for more papers by this authorA D Irving MRCP, FRCS, A D Irving MRCP, FRCS Consultant Surgeon Department of Surgery, Stracathro Hospital, Brechin, AngusSearch for more papers by this author First published: 01 April 1989 https://doi.org/10.1111/j.1742-1241.1989.tb08702.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume43, Issue4April 1989Pages 165-166 RelatedInformation

CROHN'S DISEASE OF A MECKEL'S DIVERTICULUM OCCURRING IN A CASE OF JEJUNAL DIVERTICULITIS.

Journal Article Crohn's disease of a meckel's diverticulum occurring in a case of jejunal diverticulitis Get access D Solomons, D Solomons Bristol Royal Infirmary and Department of Pathology, University of Bristol Search for other works by this author on: Oxford Academic Google Scholar M E H Halford M E H Halford Bristol Royal Infirmary and Department of Pathology, University of Bristol Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 51, Issue 12, December 1964, Pages 910–913, https://doi.org/10.1002/bjs.1800511211 Published: 06 December 2005