Nadir Bir Akut Karın Nedeni: Jejunal Divertikül Perforasyonu

Jejunal divertikülozis nadir görülen bir hastalıktır. Prevalansı yaşla doğruorantılı olarak artmakta, 6. ve 7. dekadlarda en üst düzeye ulaşmaktadır.Jejunal divertiküller genellikle asemptomatik seyirlidir ancak, perforasyongeliştiğinde ciddi morbidite ve hatta mortaliteye neden olabilir. Acil servisekarın ağrısı ile başvuran, ilk muayenede ve görüntülemede anormal bulgusaptanmayan, yatışının 48. Saatinde akut karın nedeniyle ameliyata alınan vejejunal divertikül perforasyonu saptanan, intraoperatif arrest nedeniyle exitusgelişen hasta ile ilgili deneyimimizi paylaşmak istedik.

A Rare Acute Abdomen: Jejunal Diverticul Perforation

Jejunal diverticulosis is a rare disease. The prevalence increases with age, reaching the highest level in the 6th and 7th decades. Jejunal diverticulum is usually asymptomatic but may cause serious morbidity and even mortality when perforation develops. We wanted to share our experience with the patient who presented with an emergency department abdominal pain, who had no abnormal findings on the first examination and imaging, who was operated on due to acute abdomen at the 48th hour of hospitalization and who developed jejunal diverticulum perforation and developed exitus due to intraoperative arrest.

___

  • Makris K, Tsiotos GG, Stafyla V, et al. Small intestinal nonmeckelian diverticulosis. J Clin Gastroenterol 2009; 43: 201-7.
  • Tsiotos GG, Farnell MB, Ilstrub DM. Non meckelian jejunal or ileal diverticulosis: an analysis of 112 cases. Surgery 1994; 116: 726-31.
  • Chugay P, Choi J, Dong XD. Jejunal diverticular disease complicated by enteroliths: reports of two different presentations. World J Gastrointest Surg 2010; 2: 26-9.
  • Ross CB, Richards WO. Diverticular disease of the jejunum and its complications. Am Surg 1990;56:319-56.
  • Coulier B, Maldague P, Bourgeois A, et al. Diverticulitis of the small bowel: CT diagnosis. Abdom Imaging 2007; 32: 228-33.
  • Gayer G, Zissin R, Apter S, et al. Acute diverticulitis of the smal bowel: CT findings. Abdom Imaging 1999; 24: 452-5.
  • de Bree E, Grammatikakis J, Christodoulakis M, et al. The clinical significance of acquired jejunoileal diverticula. Am J Gastroenterol 1998; 93: 2523- 28.
  • Schloericke E, Zimmermann MS, Hoffmann M, et al. Complicated jejunal diverticulitis: a challenging diagnosis and difficult therapy. Saudi J Gastroenterol 2012; 18: 122-8.
  • Palder SB, Frey CB. Jejunal diverticulosis. Arch Surg 1988; 123: 889-94.
  • Kouraklis G, et al. Diverticular disease of the small bowel: report of 27 cases. Int Surg. 2001; 86: 235-9.