Grubbs Jordan, Huerta Sergio
University of Texas Southwestern Medical Center and VA North Texas Health Care System, United States.
Int J Surg Case Rep. 2017;40:77-79. doi: 10.1016/j.ijscr.2017.09.011. Epub 2017 Sep 15.
Jejunal diverticular (JD) disease is an uncommon occurrence that frequently present as a diagnostic dilemma. The correct diagnosis from complications of JD is typically made at laparotomy. Most JD are asymptomatic. Of clinically significant small bowel diverticula, only 15% present with surgical problems including obstruction, gastrointestinal bleed, and perforation.
A 90-year-old man presented to the hospital with abdominal pain. He was clinically stable with local tenderness in the left lower quadrant. Computed tomography demonstrated a dot of free air near the sigmoid and sigmoid diverticula. He continued to have pain and clinically deteriorated following a short period of observation. He underwent an exploratory laparotomy that revealed perforated JD.
Perforation from JD is exceedingly rare. Due to their infrequent clinical significance, complications from JD are difficult to diagnose and therapeutic options are typically made intraoperatively. Any deviation from the expected positive pathway in the management of a suspected entity should prompt an immediate reassessment as well as definitive therapeutic options.
空肠憩室病并不常见，常表现为诊断难题。通常在剖腹手术时才能从空肠憩室并发症中做出正确诊断。大多数空肠憩室无症状。在具有临床意义的小肠憩室中，只有15%会出现包括梗阻、胃肠道出血和穿孔在内的手术问题。
一名90岁男性因腹痛入院。他临床状况稳定，左下腹有局部压痛。计算机断层扫描显示乙状结肠附近有游离气体点及乙状结肠憩室。经过短时间观察后，他持续疼痛且临床状况恶化。他接受了剖腹探查术，结果显示为空肠憩室穿孔。
空肠憩室穿孔极为罕见。由于其临床意义不常见，空肠憩室并发症难以诊断，治疗方案通常在术中确定。在疑似疾病的管理中，任何偏离预期阳性路径的情况都应立即重新评估并确定明确的治疗方案。
