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A Retrospective, Unicentric Evaluation of Complicated Diverticulosis Jejuni:
Symptoms, Treatment, and Postoperative Course
#MMPMID26618161
Téoule P
; Birgin E
; Zaltenbach B
; Kähler G
; Wilhelm TJ
; Kienle P
; Rückert F
Front Surg
2015[]; 2
(?): 57
PMID26618161
show ga
BACKGROUND: In contrast to the diverticulosis of the colon, jejunal
diverticulosis is a rare condition. The incidence is 0.06-5% in large autopsy
series. Complicated diverticulosis jejuni (CDJ) often presents with unspecific
symptoms. Therefore, diagnosis is often a challenging process and due to the
clinical rarity generally valid recommendation of perioperative management does
not exist. PATIENTS AND METHODS: We considered only patients who were operated in
our center between April 2007 and August 2014. Patients were identified by data
bank search via International Statistical Classification of Diseases and Related
Health Problems diagnosis code K57.10. Data were manually screened, and patients
with Meckel's and duodenal diverticula were excluded from this study. Eleven
consecutive patients with CDJ were finally included in this study. We analyzed
symptoms, diagnostic procedures, surgical treatment, and postoperative morbidity
and mortality. RESULTS: The median age of our patients was 76?years (range:
34-87). CDJ presented most frequently as intestinal bleeding or as
diverticulitis. Clinical symptoms were unspecific abdominal pain, hematemesis or
melena, ileus, nausea, and emesis as well as patients with acute abdomen.
Esophagogastroduodenoscopies confirmed CDJ in two of the three patients. An
abdominal computed tomography scan only helped to diagnose CDJ in two of the 10
patients. Eight (72.7%) patients received an open segmental resection with
primary anastomosis. In three (27.3%) cases, a reoperation was necessary. Overall
morbidity rate was 45.5%, and perioperative mortality was 9.1%. CONCLUSION: Due
to the acute character of the disease, patients with CDJ are seriously ill. To
diagnose patients with CDJ remains challenging as diagnostic investigations are
usually not helpful in confirming the diagnosis. Still, diagnosis of CDJ is most
frequently confirmed intraoperatively.
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