Multiple giant diverticula of the foregut causing upper gastrointestinal obstruction

Enterolith ileus and jejunal diverticulitis from jejunal diverticulosis: the complications of a rare gastrointestinal entity

Small bowel diverticulosis is rare. False diverticula form in the jejunum, and less commonly, the ileum. As with their large bowel counterparts, these diverticula provide a pocket for stasis of bowel content, leading to the formation of enteroliths. This case report highlights two complications from jejunal diverticulosis: jejunal diverticulitis and a small bowel obstruction as a result of enterolithiasis; the latter being a rare entity which should be a differential diagnosis for any individual presenting with gastrointestinal obstructive symptoms and radiological evidence of small bowel diverticulosis.

Diverticular disease of the small bowel: a rare cause of the duodenojejunal flexure obstruction (a case report)

The small bowel is the least common site for diverticula in the entire gastrointestinal tract. Chronic upper intestinal obstruction due to diverticula is very rare. We report a case of multiple small bowel diverticula causing mechanical obstruction of the duodenojejunal flexure.

Acute Abdomen in a 91-Year-Old Male due to Perforated Jejunal Diverticulitis

Non-Meckel small intestine diverticular disease is a rare and mostly asymptomatic condition. However, rare cases of acute and emergent complications bear a high mortality rate. We report a case of a 91-year-old male that presented with an acute abdomen due to perforated jejunal diverticulitis. A review of the literature and key points of the condition are depicted. Although jejunal diverticulosis is rare, it must be considered in the differential diagnosis, especially in the elderly with signs of ambiguous abdominal pain and peritonitis.

A rare case of multiple jejunal diverticulosis presenting as intestinal obstruction

Diverticulosis is rare in jejunum and its unusual presentation of mechanical obstruction is difficult to diagnose pre-operatively. We report a case of a 54-year old male patient who had symptoms of general abdominal pain and vomiting off and on for three years. He had been assessed elsewhere and had received a course of anti-tubercular treatment empirically based on features of recurrent intestinal obstruction due to prevalence of tuberculosis in this region. The patient had presented himself with signs and symptoms of dynamic intestinal obstruction. On examination, the abdomen was found to be swollen with a central abdominal distension and hyperactive bowel sounds. The erect abdominal radiograph showed multiple air-fluid levels and dilated jejunal loops. Following this, the patient underwent an emergency exploratory laparotomy. This revealed multiple jejunal diverticulae, multiple bands and adhesions involving jejunum and proximal ileum. The bands and adhesions were removed and the jejunum was resected along with the inflamed diverticulae.

Postdiverticular stasis-introduction of a new etiology for small intestine obstruction: a case series

Introduction. Intestinal obstruction in the setting of Meckel's diverticulum in young age and with orange and meat bezoar is a rare, previously unreported condition. Since the obstruction point is located immediately after Meckel's diverticulum in our patients, we attempt to introduce “localized peristalsis insufficiency” as a new etiology for small intestine obstruction while reviewing the findings of previous studies. Conclusion. Intestinal obstruction in the setting of Meckel's diverticulum and with orange and meat bezoar is a rare, previously unreported condition. Considering the previous reports, we may present the theory of localized peristalsis insufficiency in patients with Meckel's diverticulum.

Enterolith ileus: liberated large jejunal diverticulum enterolith causing small bowel obstruction in the setting of jejunal diverticulitis

We present an 80-year-old man with multiple medical problems, and acute abdominal pain with feculent emesis. An unenhanced CT examination of the abdomen and pelvis demonstrated jejunal diverticulitis and findings of high-grade small bowel obstruction caused by a large enterolith. Enterolith ileus has rarely been reported in the radiology literature. This phenomenon has occasionally been reported in the surgical and gastroenterology literature. We highlight the CT findings associated with enterolith ileus in the setting of jejunal diverticulitis, to alert radiologists to this unusual diagnosis.

Jejunal Diverticular Perforation due to Enterolith

Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. Although there is no consensus on the management of asymptomatic jejunal diverticular disease, some complications are potentially life-threatening and require early surgical treatment. Small bowel perforation secondary to jejunal diverticulitis by enteroliths is rare. The aim of this study was to report a case of small intestinal perforation caused by a large jejunal enterolith. An 86-year-old woman was admitted with signs of diffuse peritonitis. After initial fluid recovery the patient underwent emergency laparotomy. The surgery showed that she had small bowel diverticular disease, mainly localized in the proximal jejunum. The peritonitis was due to intestinal perforation caused by an enterolith 12 cm in length, localized inside one of these diverticula. The intestinal segment containing the perforated diverticulum with the enterolith was removed and an end-to-end anastomosis was done to reconstruct the intestinal transit. The patient recovered well and was discharged from hospital on the 5th postoperative day. There were no signs of abdominal pain 1 year after the surgical procedure. Although jejunal diverticular disease with its complications, such as formation of enteroliths, is difficult to suspect in patients with peritonitis, it should be considered as a possible source of abdominal infection in the elderly patient when more common diagnoses have been excluded.

Multiple giant diverticula of the jejunum causing intestinal obstruction: report of a case and review of the literature

Multiple diverticulosis of jejunum represents an uncommon pathology of the small bowel. The disease is usually asymptomatic and must be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain or discomfort. Related complications such as diverticulitis, perforation, bleeding or intestinal obstruction appear in 10-30% of the patients increasing morbidity and mortality rates. We herein report a case of a 55 year-old man presented at the emergency department with acute abdominal pain, vomiting and fever. Preoperative radiological examination followed by laparotomy revealed multiple giant jejunal diverticula causing intestinal obstruction. We also review the literature for this uncommon disease.

Jejunal diverticulae: reports of two cases with review of literature

INTRODUCTION

Jejunal diverticulosis (JD) is a rare disease of elderly people. Majority of diagnosed individuals are asymptomatic and found incidentally. The disease is clinically significant because of associated potential risk of serious complications. Due to the rarity and variable presentation of this clinical entity, diagnosis is often difficult and delayed, resulting in unnecessary morbidity and mortality. Clinical presentations, signs, diagnosis, complications and treatment of JD are discussed through a review of the literature and report of two cases.

METHODS

A literature review was done for analysis of diagnosis, treatment and complications of JD. Two cases of JD diagnosed and treated in our institution are also presented.

CONCLUSION

JD is a rare disease which has variable presentations and thus poses a challenge to our diagnostic skills. Awareness about complications and presentation of the condition is needed for early detection and avoiding unnecessary mortality.

Complicated jejunal diverticulosis: A case report with literature review

CONTEXT

Jejunal diverticuli are rare and usually asymptomatic. More commonly, they are seen as incidental findings on CT images, enteroclysis, or during surgery. Complications such as bleeding, perforation, obstruction, malabsorption, diverticulitis, blind loop syndrome, volvulus, and intussusceptions may warrant surgical intervention.

CASE REPORT

We report a case of 47-year old woman who had suffered from intestinal obstruction for 3 days. The symptoms did not improve after conservative treatment. An exploratory laparotomy found small bowel obstruction due to proximal jejunal diverticulum with an adhesion epiploic band. Strangulation of the jejunum resulted from the internal hernia caused by the band. The band was removed and the proximal jejunum segmentally resected. The postoperative course was uneventful.

CONCLUSION

Although this phenomenon is rare, we should keep in mind that intestinal diverticulosis may induce intestinal obstructions of different kinds, repeat physical examinations and X-ray films are needed and enteroclysis studies or CT scan are helpful in diagnosis. Surgery is indicated for acute abdominal or repeated intestinal obstruction.