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多发同时性小肠憩室穿孔

Multiple simultaneous small intestinal diverticular penetrations.

作者信息

Miyata Masahide, Tazawa Hirofumi, Saito Akihisa, Kuraoka Kazuya, Tashiro Hirotaka

机构信息

Department of Surgery, NHO Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama, Kure 737-0023, Hiroshima, Japan.

Department of Diagnostic Pathology, NHO Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama, Kure, 737-0023, Hiroshima, Japan.

出版信息

J Surg Case Rep. 2025 Aug 23;2025(8):rjaf659. doi: 10.1093/jscr/rjaf659. eCollection 2025 Aug.

Abstract

Jejunal diverticulosis is a rare condition. Here, we report a rare case of multiple simultaneous small intestinal diverticular penetrations. An 82-year-old man was admitted with a chief complaint of slurred speech. The patient had fever and elevated C-reactive protein (CRP) levels. Incidentally, two abscesses with increased density in the surrounding fatty tissue were identified using computed tomography. An emergency surgery was performed. A series of diverticula were found on the mesenteric side, spanning the area of abscess formation. We performed a partial resection of the jejunum, including abscess formation, and functional end-to-end anastomosis. Pathological examination indicated two instances of acute pyogenic diverticulitis with penetration. No cases of multiple simultaneous diverticular penetrations have been reported. However two previous reports described that of perforations. Most reports involved partial resection of the jejunum, including the perforated or penetrated site. Here, we report a rare case of multiple simultaneous small intestinal diverticulum penetrations.

摘要

空肠憩室病是一种罕见的病症。在此,我们报告一例罕见的同时发生多处小肠憩室穿孔的病例。一名82岁男性因言语不清为主诉入院。患者发热且C反应蛋白(CRP)水平升高。偶然间,通过计算机断层扫描发现周围脂肪组织密度增加的两处脓肿。遂进行了急诊手术。在肠系膜侧发现一系列憩室,其范围覆盖脓肿形成区域。我们对包括脓肿形成部位在内的空肠进行了部分切除,并进行了功能性端端吻合。病理检查显示有两例急性化脓性憩室炎伴穿孔。此前未见同时发生多处憩室穿孔的病例报道。然而,之前有两篇报道描述了憩室穿孔的情况。大多数报道都涉及包括穿孔或穿透部位在内的空肠部分切除术。在此,我们报告一例罕见的同时发生多处小肠憩室穿孔的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4c/12374801/06b4294c7fb0/rjaf659f1.jpg

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