Learning objectives
After completion of this article, the reader should be ableto :
- Identify the basic semiotic signs that can be used to diagnose jejunal diverticulitis
- Illustrate the different possible complications of jejunal diverticulitis
- Discuss the diagnostic difficulties through clinical cases ranging from the simplest to the most complicated (establish an alternative diagnosis).
Background
Jejunal diverticulitis is a rare entity with a higher prevalence among patients between 60 and 70 years.
It is most often considered as an incidental finding, but, it can have complications such as perforation, abscess, generalized peritonitis, fistula, obstruction and bleeding
Because the clinical presentation of complicated jejunal diverticulitis is generally nonspecific, diagnosis is very difficult
CT with multi-slice acquisitions and multiplanar reconstructions is currently the key examination for the diagnosis
Surgery, including resection of the diseased bowel portion with direct anastomosis, is the treatment...
Findings and procedure details
Diverticulitis is less frequently described in the jejunum than in the colon, probably because of larger diverticula size, better intra luminal flow, and relatively more sterile intestinal contents.
DEFINITION:
Acquired small bowel diverticulum corresponds to an herniation of the intestinal mucosa and submucosa with no muscular layer in the diverticular wall unlike congenital Meckel's diverticulum
Jejunal diverticulitis results from the combination of two factors:
-*the stasis of the intestinal contents in the diverticulum
-*the mucosal edema obstructing the collar favouring intradiverticular microbial growth.
CLINICAL MANIFESTATION:...
Conclusion
Jejunal diverticulitis is a rare cause of acute abdomen and is diagnosed preoperatively only infrequently.
CT currently appears as the examination of choice in the diagnostic and prognostic approach of this pathology. It identifies, locates and appreciates the importance of the infectious process and may, in some cases, directly recognize the offending diverticulum, thereby ruling out other abdominal inflammatory conditions.
Personal information and conflict of interest
B. Gargouri; Sfax/TN - nothing to disclose N. Toumi; Sfax/TN - nothing to disclose S. Sellami; Tunis/TN - nothing to disclose H. Njeh; Sfax/TN - nothing to disclose H. Harbi; Sfax/TN - nothing to disclose K. Ben Mahfoudh; 3000/TN - nothing to disclose
References
B. Abboud, R. Aouad, J. B. Jaoude, and C. Ghorra, “A rare cause of acute abdomen: Jejunal diverticulitis,” Press. Medicale, vol. 37, no. 3 PART 1, pp. 416–419, 2008, doi: 10.1016/j.lpm.2007.05.036.
A. Syllaios, “Reply to the letter to the editor: Comment to jejunal diverticulitis mimicking small bowel perforation: Case report and review of the literature,” Chir., vol. 113, no. 5, p. 720, 2018, doi: 10.21614/chirurgia.113.5.720.
T. H. E. S. Intestine, C. Hermon, and A. John, “(not meckel’s),” 2015.
H. E. Rodriguez, M. F. Ziauddin, E....