Small intestine diverticulum complicated by diverticulitis and enterolithiasis: Case report
DOI:
https://doi.org/10.33448/rsd-v12i14.44560Keywords:
Diverticulosis; Small intestine; Diverticulitis.Abstract
Diverticula of the small intestine are a rare condition, often asymptomatic, but can present complications such as diverticulitis, bleeding and formation of enteroliths, which end up becoming a diagnostic challenge. With non-specific symptoms, they often require imaging tests, with computed tomography being the one that provides the greatest help for diagnosis. Although initially conservative management is possible in cases of obstruction secondary to enteroliths, the best alternative is surgical treatment for most complications. As it presents a mortality rate of up to 40% in cases of perforation, it is a differential diagnosis to be taken into account in the case of an acute abdomen, especially in the elderly population. This work aims to present a case of small diverticula complicated with diverticulitis and intestinal obstruction due to enterolith formation, as well as the images that helped with the diagnostic definition and the surgical treatment adopted that was successful in resolving the condition.
References
Brito, M. C. B., Costallat, B. L., Martins, D. L. & Prando, A. (2011). Diverticulite jejunal: relato de caso. Radiologia Brasileira, 44(2), 135–136. https://doi.org/10.1590/S0100-39842011000200015
Chaudhery, B., Newman, P. A., & Kelly, M. D. (2014). Small bowel obstruction and perforation secondary to primary enterolithiasis in a patient with jejunal diverticulosis. BMJ case reports, 2014, bcr2014203833. https://doi.org/10.1136/bcr-2014-203833
Chugay, P., Choi, J., & Dong, X. D. (2010). Jejunal diverticular disease complicated by enteroliths: Report of two different presentations. World journal of gastrointestinal surgery, 2(1), 26–29. https://doi.org/10.4240/wjgs.v2.i1.26
Duggan, W. P., Ravi, A., Chaudhry, M. A., Ofori-Kuma, F., & Ivanovski, I. (2021). Isolated perforated jejunal diverticulitis: a case report. Journal of surgical case reports, 2021(1), rjaa587. https://doi.org/10.1093/jscr/rjaa587
Fronticelli, C. M., Bellora, P., Ferrero, A., Anselmetti, G. C., Passarino, G., & Burlo, P. (1996). Complicated jejunal diverticulosis: report of a case. Surgery today, 26(3), 192–195. https://doi.org/10.1007/BF00311506
Grubbs, J., & Huerta, S. (2017). Perforated jejunal diverticulitis in a nonagenarian veteran: A case report. International journal of surgery case reports, 40, 77–79. https://doi.org/10.1016/j.ijscr.2017.09.011
Herbetko, J., & Brunton, F. J. (1991). Enteroliths of small bowel diverticula. Clinical radiology, 43(5), 311–313. https://doi.org/10.1016/s0009-9260(05)80536-7
Hoskin, S., MacKenzie, D., Osman, M., & Oliphant, R. (2019). Enterolithiasis as a complication of a jejunal diverticulum: an unusual case of small bowel obstruction. ANZ journal of surgery, 89(4), E156–E157. https://doi.org/10.1111/ans.14150
Kornprat, P., Langner, C. & Mischinger H. J. (2005). Enterolithiasis in jejunal diverticulosis, a rare cause of obstruction of the small intestine: a case report. Wiener Klinische Wochenschrift, 117(7-8), 297–299. https://doi.org/10.1007/s00508-004-0277-8
Leigh, N., Sullivan, B. J., Anteby, R., & Talbert, S. (2020). Perforated jejunal diverticulitis: a rare but important differential in the acute abdomen. Surgical case reports, 6(1), 162. https://doi.org/10.1186/s40792-020-00929-3
Mazahreh, T. S., Aleshawi, A. J., Alorjani, M. S., Elayyan, R., & Al-Zoubi, N. A. (2019). Arteriovenous malformations within jejunal diverticulosis: case report and literature review. BMC surgery, 19(1), 70. https://doi.org/10.1186/s12893-019-0538-0
McCallion, W. A., Higgins, P. M. & Dane, T. E. (1992). Enterolith obstruction of the small bowel. The Ulster medical journal, 61(2), 179–181.
Merchán-Hamann, E., & Tauil, P. L. (2021). Proposta de classificação dos diferentes tipos de estudos epidemiológicos descritivos. Epidemiologia e servicos de saude: revista do Sistema Unico de Saude do Brasil, 30(1). https://doi.org/10.1590/s1679-49742021000100026
Molina, G. A., Ojeda, R. H., Jimenez, G., Heredia, A., Cadena, C. A., & Martic, D. (2023). Small bowel volvulus due to jejunal diverticula: a rare case of acute abdomen. Journal of surgical case reports, 2023(5), rjad249. https://doi.org/10.1093/jscr/rjad249
Patel, V. A., Jefferis, H., Spiegelberg, B., Iqbal, Q., Prabhudesai, A., & Harris, S. (2008). Jejunal diverticulosis is not always a silent spectator: a report of 4 cases and review of the literature. World journal of gastroenterology, 14(38), 5916–5919. https://doi.org/10.3748/wjg.14.5916
Pereira, A. S., Shitsuka, D. M., Pereira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica (1). Núcleo de Tecnologia Educacional da Universidade Federal de Santa Maria. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1
Sykes, B. A., & Kapadia, C. R. (2021). Enterolith ileus and jejunal diverticulitis from jejunal diverticulosis: the complications of a rare gastrointestinal entity. BMJ case reports, 14(6), e243252. https://doi.org/10.1136/bcr-2021-243252
Steenvoorde, P., Schaardenburgh, P., & Viersma, J. H. (2003). Enterolith ileus as a complication of jejunal diverticulosis: two case reports and a review of the literature. Digestive surgery, 20(1), 57–60. https://doi.org/10.1159/000068852
Yağmur, Y., Aldemir, M., Büyükbayram, H., & Taçyildiz, I. (2004). Multiple jejunal diverticulitis with perforation in a patient with systemic lupus erythematosus: report of a case. Surgery today, 34(2), 163–166. https://doi.org/10.1007/s00595-003-2653-9
Yeung, E., Kumar, V., Dewar, Z., & Behm, R. (2020). Rare aetiology of abdominal pain: contained abscess secondary to perforated jejunal diverticulitis. BMJ case reports, 13(9), e235974. https://doi.org/10.1136/bcr-2020-235974
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Copyright (c) 2023 Pedro Henrique Barbosa Fernandes; Michel Mendes Camillo; Magali da Silva Sanches Machado; Kilder Carmo dos Santos; Silvio Rodrigo Arevalos Davalos; Gabriel Galeazzi Corradi
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