Diverticulosis of the proximal part of the jejunum causing intestinal obstruction - case report
Kowalski, G.; Żądło, D.; Gawrychowski, J.
Wiadomosci Lekarskie 70(6 Pt 1): 1146-1150
2017
ISSN/ISBN: 0043-5147 PMID: 29478994 Document Number: 692570
Diverticulosis is a rare disease with a multifactorial aetiology, with a large majority in the elderly. It is characterized by a mildly symptomatic and non-specific clinical symptom. Unequivocal diagnosis can be difficult and not always possible before intraoperative examination. Delayed diagnosis can result in life-threatening consequences such as intestinal perforation or hemorrhage. A case of an 86-year-old patient with abdominal pain, nausea, and vomiting lasting for 2 days was reported. In the physical examination of the deviation from the normal state, general abrasion, flatulence and tenderness were found in the mesogastric abdominal area. In the past 6 months, the patient reported weight loss and a change in bowel movements. In laboratory tests, low leucocytosis, with normal levels of C-reactive protein. Despite intensive treatment, no improvement in general condition was observed. Due to persistent abdominal pain and gastrointestinal symptoms, it was decided to perform reconnaissance laparotomy. Several diverticulae of the initial small intestine were found in the intestine at ca. 20 cm from the Treitz ligament. The intestines were decompress by cutting them. Due to localization of lesions, no inflammation, perforation or haemorrhage, age and general condition of the patient, resection of the diseased segment of the small intestine was rescued. Perioperative and postoperative course without complications. Patient was discharged home in good general condition 10 days after surgery.