Case report Ileal diverticulitis with covered perforation complicated by pulmonary embolism – case report
Authors:
V. Válek jr. 1; M. Svoboda 2; D. Bartušek 1; V. Procházka 2; M. Mechl 1; A. Šprláková-Puková 1
Authors‘ workplace:
Klinika radiologie a nukleární medicíny Lékařské fakulty Masarykovy Univerzity – Fakultní nemocnice Brno
1; Chirurgická klinika lékařské fakulty Masarykovy univerzity – Fakultní nemocnice Brno
2
Published in:
Rozhl. Chir., 2023, roč. 102, č. 1, s. 32-36.
Category:
Case Report
doi:
https://doi.org/10.33699/PIS.2023.102.1.32–36
Overview
Diverticulitis of the ileum is an inflammatory complication of diverticulosis. It is an uncommon cause of acute abdomen that can have a very serious course, leading, for example, to intestinal perforation or bleeding. Imaging findings are very often negative and the true cause of the condition is only revealed peroperatively. In this case report, we present a case of perforated ileal diverticulitis in a patient with bilateral pulmonary embolism. This was the main reason for conservative management in the first period of time. After resolution of the pulmonary embolism, resection of the affected bowel segment was performed at the time of the next attack.
Keywords:
computed tomography – Pulmonary embolism – perforation – ultrasonography – ileal diverticulitis
Sources
1. Adamová Z. Divertikulární nemoc tračníku. Rozhl Chir. 2011;90:463–477.
2. Robek O, Marek F, Penka I, et al. Chirurgické řešení komplikací divertikulózy jejuna. Rozhl Chir. 2011;90:584–586.
3. Ceuppens A-S, Dhont S, Sneyers B, et al. Jejuno-ileal diverticulosis: A review of literature. Acta Gastroenterol Belg. 2018;81.
4. Santos Rancaño R, Delgado Morales M, Hernández García M, et al. Perforated jejunal diverticulitis: A rare cause of acute abdomen. Gastroenterología y Hepatología (English Edition) 2021;44:563–564. doi: org/10.1016/j.gastre.2020.07.022.
5. Transue DL, Hanna TN, Shekhani H, et al. Small bowel diverticulitis: an imaging review of an uncommon entity. Emerg Radiol. 2017;24:195–205. doi:org/10.1007/ s10140-016-1448-4.
6. Básti Z, Brunčák P. Perforovaná divertikulitída jejuna. Rozhl Chir. 2016;95:368–370.
7. Chapman J, Al-Katib S, Palamara E. Small bowel diverticulitis – spectrum of CT findings and review of the literature. Clinical Imaging 2021;78:240–246. doi. org/10.1016/j.clinimag.2021.05.004.
8. Hardon SF, den Boer FC, Aallali T, et al. Perforated jejunal diverticula in a young woman: A case report. International Journal of Surgery Case Reports 2021;81:105838. doi.org/10.1016/j.ijscr. 2021.105838.
9. Ejaz S, Vikram R, Stroehlein JR. Non- -Meckel small intestine diverticulitis. CRG 2017;11:462–472. doi.org/10.1159/ 000475747.
10. Rangan V, Lamont JT. Small bowel diverticulosis: pathogenesis, clinical management, and new concepts. Curr Gastroenterol Rep. 2020;22:24. doi:org/10.1007/ s11894-019-0741-2.
11. Onur MR, Akpinar E, Karaosmanoglu AD, et al. Diverticulitis: a comprehensive review with usual and unusual complications. Insights Imaging 2016;8:19–27. doi. org/10.1007/s13244-016-0532-3.
12. Levack MM, Madariaga ML, Kaafarani HM. Non-operative successful management of a perforated small bowel diverticulum. World J Gastroenterol. 2014;20:18477–18479. doi.org/10.3748/ wjg.v20.i48.18477.
13. Colvin HS, Kuenfoo C, Rajab TK, et al. Non-surgical management of recurrent perforation of a jejunal diverticulum following previous segmental bowel resection: a case report. J Med Case Reports 2009; 3:1–4. doi:org/10.4076/1752-1947-3-7318.
14. Novak JS, Tobias J, Barkin JS. Nonsurgical management of acute jejunal diverticulitis: a review. Am J Gastroenterol. 1997;92:1929–1931.
15. Lee GD, Ju S, Kim J-Y, et al. Risk factor and mortality in patients with pulmonary embolism combined with infectious disease. Tuberc Respir Dis. (Seoul) 2020;83:157–166. doi.org/10.4046/trd. 2019.0037.
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