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空肠憩室病:并发症与治疗——病例系列

Jejunal diverticulosis: complications and management - a case series.

作者信息

Betz Elise, Hofmann Kyra, Dubs Linus, Šandera Peter, Solimene Folco

机构信息

Department of General Surgery, Spitäler Schaffhausen, Geissbergstrasse 81, 8208 Schaffhausen, Switzerland.

Department of Surgery, Clinic for Visceral and Thoracic Surgery, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland.

出版信息

J Surg Case Rep. 2025 Jul 24;2025(7):rjaf569. doi: 10.1093/jscr/rjaf569. eCollection 2025 Jul.

Abstract

Jejunal diverticulosis (JD) is rare (incidence of 0.5%-6%), more common in the elderly, and often asymptomatic. However, complications like diverticulitis, perforation, obstruction and gastrointestinal bleeding pose diagnostic and management challenges. This case series describes five patients with complicated JD. Four had jejunal diverticulitis, two with free perforation requiring emergency surgery, two with chronic inflammation. The fifth patient had severe gastrointestinal bleeding undetected by conventional endoscopy requiring advanced diagnostics. Three patients with diverticulitis underwent successful segmental resection, one was managed conservatively. The patient with gastrointestinal bleeding responded to conservative management without a surgical intervention. JD can cause life threatening complications. Clinicians should suspect it in elderly patients with acute abdominal symptoms or obscure gastrointestinal bleeding. Prompt imaging and individualized management are crucial for optimizing outcomes. This report highlights the need for greater awareness of JD as a differential diagnosis in abdominal pain and gastrointestinal hemorrhage.

摘要

空肠憩室病(JD)较为罕见(发病率为0.5%-6%),在老年人中更为常见,且通常无症状。然而,憩室炎、穿孔、梗阻和胃肠道出血等并发症给诊断和治疗带来了挑战。本病例系列描述了5例复杂型JD患者。4例患有空肠憩室炎,其中2例伴有游离穿孔需要急诊手术,2例为慢性炎症。第5例患者有严重胃肠道出血,常规内镜检查未发现,需要进行高级诊断。3例憩室炎患者接受了成功的节段性切除,1例采用保守治疗。胃肠道出血患者经保守治疗有效,未进行手术干预。JD可导致危及生命的并发症。临床医生应怀疑老年患者出现急性腹部症状或不明原因的胃肠道出血时患有此病。及时的影像学检查和个体化治疗对于优化治疗效果至关重要。本报告强调需要提高对JD作为腹痛和胃肠道出血鉴别诊断的认识。

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