Vayzband Vlad, Ashraf Hamza, Esparragoza Paola
Internal Medicine, Saint Peter's University Hospital, New Brunswick, USA.
Gastroenterology and Hepatology, Saint Peter's University Hospital, New Brunswick, USA.
Cureus. 2021 Jun 25;13(6):e15930. doi: 10.7759/cureus.15930. eCollection 2021 Jun.
A 71-year-old male with a past medical history significant for chronic constipation presented to the emergency department for acute onset of severe abdominal pain. On presentation, the patient appeared to be in distress, exemplifying signs of peritonitis despite vital signs being grossly benign. CT scan established the diagnosis of a perforated jejunal diverticulitis. Initially, the patient was managed conservatively with IV fluids, antibiotics, and pain control medications. Diagnostic imaging in tandem with the patient's failure to improve incited surgical intervention with a jejunal resection and establishment of a primary anastomosis. This case illustrates additional differential diagnoses necessary for consideration in an elderly patient presenting with an acute abdomen.
一名71岁男性，有慢性便秘病史，因突发严重腹痛到急诊科就诊。就诊时，患者看起来很痛苦，尽管生命体征基本正常，但仍有腹膜炎体征。CT扫描确诊为空肠憩室炎穿孔。起初，患者接受了静脉输液、抗生素和止痛药物的保守治疗。诊断性影像学检查以及患者病情未改善促使进行了空肠切除术和一期吻合术的手术干预。该病例说明了老年急腹症患者需要考虑的其他鉴别诊断。
