JEJUNAL DİVERTİKÜLOZ PERFORASYONU: NADİR BİR AKUT KARIN NEDENİ
Jejunal divertikülozis tanısı zor konabilen, yüksek morbidite ve mortaliteye neden olabilen nadir lezyonlardır. Genellikle asemptomatiktir, ancak bazen ishal, kronik karın ağrısı, şişkinlik, akut divertikülit, kanama, bağırsak tıkanıklığı ve delinme ile kendini gösterir. Bu yazıda jejunumda divertikül perforasyonu sonucu akut karın gelişen ve opere edilen bir hasta sunuldu. Acil servise ani başlayan karın ağrısı, ateş ve çarpıntı şikayetleri ile başvuran 67 yaşında kadın hastanın fizik muayenesinde yaygın karın hassasiyeti, defans ve rebound mevcuttu. Kan testlerinde WBC 15.480/ml, CRP 36 mg/l idi. Batın BT’de karında barsak ansları arasında serbest hava kesecikleri, jejunumda divertikül, diffüz kolon divertikülü, peritoneal kontaminasyon izlendi. İki ameliyat yaptık.Önce diagnostik laparaoskopi ile teşhis konarak konservatif tedavi yapıldı. Fakat iki hafta sonra karın içi apse oluştu.Tanısal laparatomi yaptık ve divertikülozisli jejunal ansı rezeke ettik. Hasta postoperatif 7. gün taburcu edildi.
Anahtar Kelimeler:
Jejunal divertikülozis, akut batın, jejunal diverticulosis
JEJUNAL DİVERTICULOSIS PERFORATION: A RARE CAUSE OF ACUTE ABDOMEN
Jejunal diverticula are rare lesions that can be difficult to diagnose and can cause high morbidity and mortality. It is usually asymptomatic,but it sometime presentation diarrhea, chronic abdominal pain, bloating, acute diverticulitis, bleeding, intestinal obstruction, and perforation. In thise article, we present a patient who was operated on for acute abdomen due to diverticulum perforation in the jejunum. A 67-year-old female patient, who presented to the emergency clinic with sudden onset of abdominal pain, fever, and palpitation had widespread abdominal tenderness, abdominal defense and rebound on physical examination. There is some abnormal blood tests. WBC was 15.480/ml, C-reactive protein was 36 mg/l.Free air sacs between the bowel loops in the abdomen, diverticula in the jejunum, diffuse colon diverticula,peritoneal contamination were observed in the abdominal CT. We made two operation.Firsly,we made diagnos and decide conservative aproch.But two weeks later,intraabdominal abscess occurred.We made diagnostic laparatomi and resected the jejunal part with jejunal divertikülozis. The patient was discharged on the 7th postoperative day.
Keywords:
jejunal diverticulosis, acut abdomen, Jejunal divertikülozis,
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- Başlangıç: 2021
- Yayıncı: İSTANBUL ATLAS ÜNİVERSİTESİ
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