Butler Joseph S, Collins Christopher G, McEntee Gerard P
Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
J Med Case Rep. 2010 Jun 7;4:172. doi: 10.1186/1752-1947-4-172.
Jejunal diverticula are rare and are usually asymptomatic. However, they may cause chronic non-specific symptoms or rarely lead to an acute presentation.
We report the case of an 82-year-old Caucasian woman presenting with a one-day history of generalized abdominal pain, with three episodes of vomiting. An abdominal X-ray displayed multiple dilated loops of the small bowel. A subsequent computed tomography scan of the abdomen and pelvis revealed a thickening of the duodenum and dilatation of the proximal jejunum. Multiple small bowel diverticula were identified with surrounding pockets of free air adjacent to the jejunal diverticula suggestive of a small bowel perforation. Our patient underwent a laparotomy, which identified multiple jejunal diverticula with two pinhole jejunal perforations and associated fecal contamination. The perforations were repaired with primary closure and extensive washout was performed.
Jejunal diverticulosis in the elderly can lead to significant morbidity and mortality and so should be suspected in those presenting with crampy abdominal pain and altered bowel habits.
空肠憩室罕见，通常无症状。然而，它们可能引起慢性非特异性症状，或极少导致急性发作。
我们报告一例82岁白种女性病例，患者有一天的全腹痛病史，并伴有三次呕吐发作。腹部X线显示多个小肠扩张袢。随后的腹部和盆腔计算机断层扫描显示十二指肠增厚，空肠近端扩张。发现多个小肠憩室，空肠憩室周围有游离气体积聚，提示小肠穿孔。我们的患者接受了剖腹手术，术中发现多个空肠憩室，有两个针孔样空肠穿孔，并伴有粪便污染。穿孔处进行了一期缝合修复，并进行了广泛冲洗。
老年人空肠憩室病可导致严重的发病率和死亡率，因此对于出现痉挛性腹痛和排便习惯改变的患者应怀疑此病。
