COMPLICATED JEJUNAL DIVERTICULA AS SURGICAL EMERGENCY: EXPERIENCE AT A TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN

Authors

  • Ijaz Ahmed
  • Mohammad Naeem
  • Ambreen Samad
  • Amir Nasir
  • Zahid Aman
  • Siddique Ahmed
  • Fazal Manan

Abstract

Background: 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 or
may give rise to symptoms like pain, flatulence and borborygmi, may produce malabsorption
syndrome or may present in emergency with different acute pathologies like perforation,
haemorrhage, obstruction, enterolith formation and inflammation. The Objective was to see the
pattern of complications in jejunal diverticula presenting as a surgical emergency. Methods: This
descriptive study was conducted at Surgical Units of the 3 tertiary care Hospitals of Peshawar, for
7 years from January 1, 2002 to December 31, 2008. Study included all patients presenting to and
admitted in Surgical Unit, Hayatabad Medical Complex, Peshawar with complicated jejunal
diverticula during the above mentioned period. Name, age, sex, other relevant data, history and
examination findings and results of investigation were recorded. Uncomplicated jejuna diverticula
were 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 1
was female. Eight out of 10 patients presented with perforation of diverticula while 1 patient had
severe inflammation of diverticulum causing pain, ileus and acute abdomen. One patient had acute
pain due to adhesion formation. Conclusion: It is seen that complicated jejunal diverticulae are
quite rare and the most common complication is perforation. Inflammation and adhesion are other
complications with which jejunal diverticula presented during this study.
Keywords: jejunal diverticula, perforation, diverticulitis, complication

References

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

Feb;75(2):175-7.

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.

Gastroenterologist 1997;5(1):78-84.

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

Today. 2004;34(2):163-6.

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.

;88:578-82.

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

;61:984-8.

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

Gastroenterol 2004;39:905-9.

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

;49:381-4.

La Denise JP, Douard R, Berger A, Cugnenc PH. Small

bowel diverticulosis complicated by perforated jejunal

diverticula: aconservative and/or surgical management?

Hepatogastroenterology 2008;55:1657-9.

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.

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Published

2010-03-01

How to Cite

Ahmed, I., Naeem, M., Samad, A., Nasir, A., Aman, Z., Ahmed, S., & Manan, F. (2010). COMPLICATED JEJUNAL DIVERTICULA AS SURGICAL EMERGENCY: EXPERIENCE AT A TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN. Journal of Ayub Medical College Abbottabad, 22(1), 157–159. Retrieved from https://demo.ayubmed.edu.pk/jamc/index.php/jamc/article/view/3113