Presentation
Acute abdomen
Patient Data
There are numerous duodenal and jejunal diverticula.
A jejunal diverticulum shows signs of micro perforation with increased density of the adjacent adipose tissue.There is also a small peritoneal effusion.
In the upper quadrants some loops are dilated with parietal hypertonus, adherent to each other.
Report of surgery
Purulent peritonitis by perforation of jejunal diverticulum in diffuse jejunal diverticulosis, adherence syndrome and median recurrent herniahocele.
Case Discussion
Jejunal diverticula are usually multiple and localized to the proximal jejunum. Jejunoileal diverticula may be composed of mucosa and submucosa only, or of all layers of the jejunal wall. The cause of jejunoileal diverticula is unclear, but intestinal dyskinesia and high intraluminal pressure have been implicated in the pathogenesis.
The most frequent complications are:
- complete small bowel obstruction due to volvulus.
- development of an abscess
- diverticular perforation
- gastrointestinal bleeding
Case courtesy: Prof Fabio Denicolò