Jambulingam Raja, Nanayakkara Gayan
General Surgery, Hywell Dda University Health Board, Haverfordwest, UK.
General Surgery, Withybush General Hospital, Haverfordwest, UK.
BMJ Case Rep. 2019 Jul 12;12(7):e228811. doi: 10.1136/bcr-2018-228811.
Jejunal diverticulosis is an underdiagnosed condition due to its relatively benign existence and uncharacteristic presentation. The complications can be very severe and, due to its often late diagnosis, patients may require urgent surgery. We present a woman who initially complained of non-specific abdominal symptoms but was diagnosed with a contained jejunal diverticular perforation relatively early. We managed her non-operatively with intravenous antibiotics from which she recovered well. She was discharged 2 days later and has remained completely well. Follow-up at 3 months showed no recurrence. Our case differs from most of the literature due to the early diagnosis and successful non-operative management of the patient. We conclude that, in cases of non-specific abdominal pain with diagnostic ambiguity, a diagnosis of small bowel diverticulosis should be considered. It should be managed non-operatively where possible.
空肠憩室病因其相对良性的存在和不典型的表现而常被漏诊。其并发症可能非常严重,且由于诊断往往较晚,患者可能需要紧急手术。我们报告一位女性患者,她最初主诉非特异性腹部症状,但相对早期就被诊断为局限性空肠憩室穿孔。我们对她进行了非手术治疗,给予静脉抗生素,她恢复良好。两天后出院,此后一直完全康复。3个月的随访显示无复发。我们的病例与大多数文献报道不同,因为该患者得到了早期诊断并成功进行了非手术治疗。我们得出结论,在诊断不明确的非特异性腹痛病例中,应考虑小肠憩室病的诊断。在可能的情况下应进行非手术治疗。