Massive Bleeding from Multiple Jejunal Diverticulosis.
- Author:
Deok Ho YIM
1
;
Yong Hoon KIM
;
Yong Hee HWANG
;
Yong Hwan JUNG
;
Haeng Ji KANG
Author Information
1. Department of Surgery, Seoul Adventist Hospital, Seoul, Korea. Hwangyon@hotmail.com
- Publication Type:Case Report
- Keywords:
Jejunal diverticulosis;
Massive bleeding
- MeSH:
Abdomen;
Abdominal Pain;
Diagnosis;
Diverticulitis;
Diverticulum*;
Emergencies;
Female;
Hemorrhage*;
Humans;
Jejunum;
Laparotomy;
Ligaments;
Lymph Nodes;
Meckel Diverticulum;
Mucous Membrane;
Physical Examination;
Rare Diseases
- From:Journal of the Korean Surgical Society
2006;70(5):402-405
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Jejunoileal diverticulosis is formed by herniation of mucosa and submucosa through the muscular layer of the bowel wall. The condition usually consists of multiple diverticula at the mesenteric border, in contrast to the true congenital Meckel's diverticulum. Small bowel diverticulum is a rare disease that can give rise to unexpected problems such as malabsorption, perforation, diverticulitis, obstruction and bleeding. Since the reported complication rate is low, uncomplicated small bowel diverticula are generally recommended to be left untreated. Bleeding from a diverticulum is often sudden and massive. We report herein a case of a 43-yearold women who presented with massive bleeding from multiple jejunal diverticula. She had been admitted to hospital one day previously with the chief complaint of severe whole abdominal pain which was aggravated progressively. On physical examination, she showed an acute, ill appearance. The abdomen was slightly distended and tender with rebound tenderness. On the abdomen CT, the jejunal wall was thickened and the mesenteric lymph nodes were enlarged. An emergency laparotomy was performed. Multiple jejunal diverticula, distributed from 20 to 100 cm distal to the ligament of Treitz, were found, along with massive bleeding from diverticulosis. A segment of the jejunum containing all diverticula was resected and end to end anastomosis was performed. Due to the relative rarity of these lesions and their complications, diagnosis is often difficult and delayed. Awareness of their tendency to cause nonspecific abdominal symptoms and serious complications may lead to earlier diagnosis and timely treatment.
