COMPLICATED JEJUNAL DIVERTICULA AS SURGICAL EMERGENCY: EXPERIENCE AT A TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN
AbstractBackground: 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
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
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.
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
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.
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
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
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
La Denise JP, Douard R, Berger A, Cugnenc PH. Small
bowel diverticulosis complicated by perforated jejunal
diverticula: aconservative and/or surgical management?
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.