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空肠憩室炎穿孔:手术及抗生素治疗

Perforated Jejunal Diverticulitis: Surgical and Antibiotic Management.

作者信息

Park Erin G, Besly Kylie, Kim Anna, Boney Colton P, Mbuko Sharon

机构信息

Medicine, Alabama College of Osteopathic Medicine, Dothan, USA.

Biomedical Sciences, Geisinger Commonwealth School of Medicine, Scranton, USA.

出版信息

Cureus. 2024 Aug 15;16(8):e66952. doi: 10.7759/cureus.66952. eCollection 2024 Aug.

Abstract

Small bowel diverticulitis occurs at a rate of 0.06% to 1.3%, mainly in individuals over 50, peaking between ages 60 and 70. Duodenal diverticula are the most common (79% of cases), followed by jejunal or ileal diverticula (18%), and diverticula in all segments combined (3%). This condition typically presents with sporadic abdominal pain and vague gastrointestinal symptoms, making diagnosis difficult. We report an 80-year-old male who presented to the emergency department with sudden, left-sided abdominal pain and nausea due to perforated jejunal diverticulitis. Despite undergoing side-to-side jejunojejunostomy and incidental appendectomy, the patient rapidly declined and expired 45 hours post-operation due to septic shock. This case highlights the scarcity of literature on jejunal diverticulitis and its treatment guidelines.

摘要

小肠憩室炎的发病率为0.06%至1.3%,主要发生在50岁以上人群,60至70岁达到高峰。十二指肠憩室最为常见(占病例的79%),其次是空肠或回肠憩室(18%),所有节段合并出现的憩室(3%)。这种情况通常表现为散发性腹痛和模糊的胃肠道症状,诊断困难。我们报告一名80岁男性,因空肠憩室炎穿孔,出现突发左侧腹痛和恶心,到急诊科就诊。尽管接受了空肠侧侧吻合术和阑尾切除术,但患者术后45小时因感染性休克迅速病情恶化并死亡。本病例凸显了关于空肠憩室炎及其治疗指南的文献稀缺。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2075/11401618/1308d50fcd63/cureus-0016-00000066952-i01.jpg

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