López Marcano Aylhin Joana, Ramia José Manuel, De la Plaza Llamas Roberto, Alonso Soledad, Gonzales Aguilar Johnny David, Kühnhardt Barrantes Andree Wolfgang
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Guadalajara. Guadalajara, España.
Servicio de Anatomía Patológica, Hospital Universitario de Guadalajara. Guadalajara, España.
Rev Gastroenterol Peru. 2017 Jul-Sep;37(3):240-245.
To perform a retrospective analysis of a series of complicated JID (jejunoileal diverticulitis) cases surgically treated in our service during the period from 2002 to 2015.
We treated 12 cases of jejunoileal complicated diverticulosis. 7 women and 5 men. The mean age was 76 years. The clinical presentation in all cases was acute abdominal pain, one with gastrointestinal bleeding. All cases had leukocytosis, neutrophilia and increased acute phase reactants. All patients underwent emergency abdominal CT.
In 11 cases, there was consistency between imaging studies and surgical findings. Diverticula were located: jejunum (9) and ileum (3). Urgent exploratory laparotomy was always done and findings were: diverticular perforation with peritonitis (7 cases), diverticular perforation with abscess (4 cases) and in one case an ischemic area with diverticular perforation after embolization. Intestinal resection and anastomosis was performed in all cases. There were no patients, in which the diagnosis of diverticulosis jejunoileal was previously known. Complications were: Clavien I (2), Clavien IIIa (1), Clavien IVb (1), Clavien V (1).
Jejunoileal diverticulitis is a rare entity, usually the first sign of onset of diverticular disease not previously known. Abdominal CT is of great diagnostic value. Resection of the affected segment is the treatment of choice.
对2002年至2015年期间在我院接受手术治疗的一系列复杂空回肠憩室炎(JID)病例进行回顾性分析。
我们治疗了12例空回肠复杂性憩室病患者。其中女性7例,男性5例。平均年龄为76岁。所有病例的临床表现均为急性腹痛,1例伴有胃肠道出血。所有病例均有白细胞增多、中性粒细胞增多及急性期反应物升高。所有患者均接受了急诊腹部CT检查。
11例患者的影像学检查与手术 findings一致。憩室位于:空肠(9例)和回肠(3例)。均进行了急诊剖腹探查,结果为:憩室穿孔伴腹膜炎(7例)、憩室穿孔伴脓肿(4例),1例为栓塞后出现缺血区伴憩室穿孔。所有病例均进行了肠切除吻合术。此前均无空回肠憩室病的诊断。并发症包括:Clavien I级(2例)、Clavien IIIa级(1例)、Clavien IVb级(1例)、Clavien V级(1例)。
空回肠憩室炎是一种罕见疾病,通常是先前未知的憩室病的首发症状。腹部CT具有重要的诊断价值。切除受累肠段是首选治疗方法。