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空肠憩室炎穿孔:一种在急腹症中罕见但重要的鉴别诊断疾病。

Perforated jejunal diverticulitis: a rare but important differential in the acute abdomen.

作者信息

Leigh Natasha, Sullivan Brianne J, Anteby Roi, Talbert Susan

机构信息

Department of General Surgery, Icahn School of Medicine at Mount Sinai St. Luke's Roosevelt Hospital, 425 West 59th Street, Suite 7B, New York, NY, 10019, USA.

Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Surg Case Rep. 2020 Jul 6;6(1):162. doi: 10.1186/s40792-020-00929-3.

Abstract

BACKGROUND

Diverticulosis of the small bowel is rare and, in most cases, discovered incidentally. However, diverticulitis and other complications are important to consider in the differential of an acute abdomen, especially in the elderly population.

CASE PRESENTATION

The patient was a 59-year-old female who presented with acute lower abdominal pain progressing to peritonitis. Computed tomography scan showed a large inflamed and perforated diverticulum on the mesenteric side of the jejunum. Exploratory laparotomy revealed a dilated proximal jejunum with a 5-cm inflamed and perforated mesenteric diverticulum. A small bowel resection with primary anastomosis was performed.

CONCLUSIONS

Jejunal diverticulitis remains a diagnostic challenge. Although uncommon, owing to its high mortality rate, it is an important clinical entity to consider and requires timely management.

摘要

背景

小肠憩室病较为罕见,多数情况下是偶然发现。然而,憩室炎及其他并发症在急腹症的鉴别诊断中很重要,尤其在老年人群中。

病例介绍

患者为一名59岁女性,表现为急性下腹痛并进展为腹膜炎。计算机断层扫描显示空肠系膜侧有一个大的发炎且穿孔的憩室。剖腹探查发现近端空肠扩张,有一个5厘米发炎且穿孔的肠系膜憩室。进行了小肠切除并一期吻合术。

结论

空肠憩室炎仍然是一个诊断难题。尽管不常见,但由于其高死亡率,它是一个需要考虑的重要临床实体,需要及时处理。

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