COMPLICATED JEJUNAL DIVERTICULA AS SURGICAL EMERGENCY: EXPERIENCE AT A TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN

Authors

  • Ijaz Ahmed
  • Mohammad Naeem
  • Ambreen Samad
  • Amir Nasir
  • Zahid Aman
  • Siddique Ahmed
  • Fazal Manan

Abstract

Background: Diverticula of small intestine are rare. Jejunal diverticula can be single or multiple.Diverticula in the jejunum tend to be large and multiple. Clinically they may be asymptomatic ormay give rise to symptoms like pain, flatulence and borborygmi, may produce malabsorptionsyndrome or may present in emergency with different acute pathologies like perforation,haemorrhage, obstruction, enterolith formation and inflammation. The Objective was to see thepattern of complications in jejunal diverticula presenting as a surgical emergency. Methods: Thisdescriptive study was conducted at Surgical Units of the 3 tertiary care Hospitals of Peshawar, for7 years from January 1, 2002 to December 31, 2008. Study included all patients presenting to andadmitted in Surgical Unit, Hayatabad Medical Complex, Peshawar with complicated jejunaldiverticula during the above mentioned period. Name, age, sex, other relevant data, history andexamination findings and results of investigation were recorded. Uncomplicated jejuna diverticulawere excluded from study. The operative findings and the type of complication were recorded.Results: Ten patients were admitted during 7 years of study. Out of all patients 9 were male and 1was female. Eight out of 10 patients presented with perforation of diverticula while 1 patient hadsevere inflammation of diverticulum causing pain, ileus and acute abdomen. One patient had acutepain due to adhesion formation. Conclusion: It is seen that complicated jejunal diverticulae arequite rare and the most common complication is perforation. Inflammation and adhesion are othercomplications with which jejunal diverticula presented during this study.Keywords: jejunal diverticula, perforation, diverticulitis, complication

References

Russel RCG, William NS, Bulstrode CJK. Bailey and Love’s

Short Practice of Surgery. 24th ed. London: Arrnold; 2004.

Gutstein D, García Caballero M, Vara Thorbeck C.

Diverticula of the small intestine. Presentation of 2 new cases

and review of the literature. Rev Esp Enferm Apar Dig. 1989

Feb;75(2):175–7.

Shanmugam RP, Shivakumar P. A rare complication of

jejunal diverticulosis. Trop Gastroenterol. 2006;27(3):134–5.

Albu E, Parikh V, Alankar S, Gerst PH. Perforated solitary

jejunal diverticulum. South Med J 1995;88:575–6.

Chow DC, Babaian M, Taubin HL. Jejunoileal diverticula.

Gastroenterologist 1997;5(1):78–84.

Yağmur Y, Aldemir M, Büyükbayram H, Taçyildiz I.

Multiple jejunal diverticulitis with perforation in a patient

with systemic lupus erythematosus: report of a case. Surg

Today. 2004;34(2):163–6.

Patel SA, al-Haddadin D, Schopp J, Cantave I, Duarte B,

Watkins JL. Gastrointestinal manifestations of amyloidosis: a

case of diverticular perforation. Am J Gastroenterol.

;88:578–82.

Woods K, Williams E, Melvin W, Sharp K. Acquired

jejunoileal diverticulosis and its complications: a review of

the literature. Am Surg. 2008;74:849–54.

Geroulakos G. Surgical problems of jejunal diverticulosis.

Ann R Coll Surg Engl 1987;69(6):266–8.

Wilcox RD, Shatney CH. Surgical implications of jejunal

diverticula. South Med J 1988;81:1386–91.

Manouras AJ, Katergiannakis VA, Stamatiadis AP, Pararas

BN, Apostolidis NS. Perforated small bowel diverticulosis.

Case report. Acta Chir Scand. 1990;156:489–90.

Chendrasekhar A, Timberlake GA. Perforated jejunal

diverticula: an analysis of reported cases. Am Surg

;61:984–8.

Koger KE, Shatney CH, Dirbas FM, McClenathan JH.

Perforated jejunal diverticula. Am Surg 1996;62:26–9.

Meagher AP, Porter AJ, Rowland R, Ma G, Hoffmann DC.

Jejunal diverticulosis. Aust NZ J Surg 1993;63:360–6.

Lempinen M, Salmela K, Kemppainen E. Jejunal

diverticulosis: a potentially dangerous entity. Scand J

Gastroenterol 2004;39:905–9.

Majeed S, Saeed A. Perforated jejunal diverticulum. Pak

Armed Forces Med J 2004;54(1):134–5.

Telgote AV; Chandak MR; Hedawoo JB. Perforated Jejunal

Diverticulum-Report of Two Cases. Bombay Hospital J

;49:381–4.

La Denise JP, Douard R, Berger A, Cugnenc PH. Small

bowel diverticulosis complicated by perforated jejunal

diverticula: aconservative and/or surgical management?

Hepatogastroenterology 2008;55:1657–9.

Durai R, Sinha A, Khan M, Hoque H, Kerwat R. Ruptured

jejunal diverticulum due to a single-band small bowel

obstruction. Scientific World Journal 2008;8:934–40.

Basile G, Buffone A, Boscarelli G, Maria S, Santagati G,

Corsaro A et al. Perforated jejunal diverticulum. [A case

report]. Ann Ital Chir 2008;79:53–6.

Published

2010-03-01

Issue

Vol. 22 No. 1 (2010): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.