Z Gastroenterol 2016; 54(06): 562-565
DOI: 10.1055/s-0042-105298
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Complicated jejunal diverticulosis – a rare but important diagnosis to consider in abdominal pain: a report of three cases

Jejunale Divertikulose – eine seltene aber wichtige Differenzialdiagnose bei unklaren abdominellen Schmerzen
B. M. Walter
1   II. Medizinische Klinik und Poliklinik, MRI der TU München, Germany
,
J. Winker
2   II. Medizinische Klinik, Rotkreuzklinikum München, Germany
,
M. Wagner
3   Allgemein- und Viszeralchirurgie, Rotkreuzklinikum München, Germany
,
A. Jung
2   II. Medizinische Klinik, Rotkreuzklinikum München, Germany
,
H. Strebel
4   III. Medizinische Klinik, Klinikum Dresden-Friedrichsstadt, Dresden, Germany
,
P. Born
2   II. Medizinische Klinik, Rotkreuzklinikum München, Germany
› Author Affiliations
Further Information

Publication History

13 January 2016



Publication Date:
10 June 2016 (online)

Abstract

Jejunal diverticulosis, a form of acquired false diverticula, is considered to be a rare clinical entity, which is mostly asymptomatic. But, in case of complications, jejunal diverticulosis can present as acute abdominal distress. Due to its rarity in clinical manifestation, jejunal diverticulosis may lead to a diagnostic and therapeutic delay. We report on 3 interdisciplinary cases of complicated jejunal diverticulosis by diverticulitis, diverticular bleeding, and perforation. We want to highlight the fact that complicated jejunal diverticulosis should be considered as a differential diagnosis in cases of unclear abdominal pain.

Zusammenfassung

Die Divertikulose des Dünndarms ist eine seltene, in den meisten Fällen auch asymptomatische Erkrankung. Jedoch ist das klinische Bild einer komplikativen jejunalen Divertikulose das eines unklaren Abdomens. Aufgrund der Seltenheit der Erkrankung kann dies zu einer relevanten Verzögerung hinsichtlich adäquater Diagnostik und Therapie führen. Wir berichten über 3 interdisziplinär behandelte Fälle, die exemplarisch die häufigsten Komplikationen (Entzündung, Perforation und gastrointestinale Blutung) der jejunalen Divertikulose beschreiben. Wir möchten damit darauf hinweisen, dass in Fällen eines unklaren abdominalen Beschwerdebilds, die jejunale Divertikulose als Differenzialdiagnose berücksichtigt werden sollte.

 
  • References

  • 1 Patel V, Jeffris H, Spiegelberg B et al. Jejunal diverticulosis is not always a silent spectator: a report of 4 cases and review of the literature. World J Gastroenterol 2008; 14: 5916-5919
  • 2 Lempinen M, Salmela K, Kemppainen E. Jejunal diverticulosis: a potentially dangerous entity. Scand J Gastroenterol 2004; 74: 905-909
  • 3 Moris D, Vernadakis S. Jejunal diverticulosis as the obscure cause of acute abdominal pain. Surgery. 155. Elsevier; 2014: 1093-1094
  • 4 Hamada N, Ishizaki N, Shirahama K et al. Multiple duodeno-jejunal diverticula causing massive intestinal bleeding. J Gastroenterol 2000; 35: 159-163
  • 5 Rodriguez H, Ziauddin M, Quiros E et al. Jejunal diverticulosis and gastrointestinal bleeding. J Clin Gastroenterol 2001; 33: 412-414
  • 6 Yaqub S, Evensen B, Kjellevold K. Massive rectal bleeding from aquired jejunal diverticula. World J Emerg Surg 2011; 6: 17
  • 7 Schloericke E, Zimmermann M, Hoffmann M et al. Complicated jejunal diverticulitis: a challenging diagnosis and difficult therapy. Saudi J Gastroenterol 2012; 18: 122-128
  • 8 De Groote J, Snauwaert C, Defreyne L. An unusual case of acute intestinal hemorrhage. Gastroenterology 2015; 148: e10-e11
  • 9 Makris K, Tsiotos G, Stafyla V et al. Small intestinal nonmecklian diverticulosis. J Clin Gastroenterol 2009; 43: 201-207
  • 10 Zager J, Garbus J, Shaw J et al. Jejunal diverticulosis: a rare entitiy with multiple presentations, a series of cases. Dig Surg 2000; 17: 643-645
  • 11 Coulier B, Maldague P, Bourgeois A et al. Diverticulitis of the small bowel: CT diagnosis. Abdom Imaging 2007; 32: 228-233
  • 12 Macari M, Faust M, Liang H et al. CT of jejunal diverticulitis: Imaging findings, differential diagnosis, and clinical management. Clin Radiol 2007; 62: 73-77
  • 13 Sioulas AD, Polymeros D, Beis D et al. Jejunal diverticulosis. Ann Gastroenterol 2013; 26: 354
  • 14 Hsu WH, Wu IC, Hu HM. Bleeding from jejunal diverticulum located by angiography and treated by enteroscopy. Gastrointest Endosc 2015;Oct 22.
  • 15 Yan A, Shindel A, Buxbaum J. Massive obscure bleeding from a jejunal diverticulum (with video). Gastrointest Endosc 2015; 81: 1289-1290
  • 16 Fernandes C, Pinho R, Rodrigues A et al. Argon plasma coagulation of a bleeding angioectasia in a jejunal diverticulum by single-balloon enteroscopy. Endoscopy 2015; 47: E 62