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Complicated Jejunal Diverticulosis: Small Bowel Volvulus with Obstruction

机译:复杂的空肠憩室:小肠扭转性肠梗阻

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摘要

The incidence of the diverticulum of the small bowel varies from 0.2-1.3% in autopsy studies to 2.3% when assessed on enteroclysis. It occurs mostly in patients in the 6th decade of their life. Of all the small bowel diverticuli, jejunal diverticulum is the most common type. This rare entity is usually asymptomatic. However, they may cause chronic non-specific symptoms for a long period of time like dyspepsia, chronic postprandial pain, nausea, vomiting, borborgymi, alternating diarrhoea and constipation, weight loss, anaemia, steatorrhea or rarely lead to complications like haemorrhage, obstruction, perforation. Obstruction can be due to enterolith, adhesions, intussusception, and volvulus. The condition is difficult to diagnose because patients are generally presented with symptoms that mimic other diseases. It is important for clinicians to have awareness of this entity. Here, we present a case of multiple jejunal diverticuli with a history of repeated attacks of diverticulitis over past 20 years, which were misdiagnosed and now presented with intestinal obstruction due to volvulus of the involved segment along with mesentery around its axis. Resection of the diverticuli segment of jejunum was done with end-to-end jejuno-jejunal anastomosis. The patient is asymptomatic since 10 months of follow-up.
机译:小肠憩室的发生率在尸检研究中为0.2-1.3%,而在肠溶分析中评估为2.3%。它主要发生在患者生命的第六个十年中。在所有小肠憩室中,空肠憩室是最常见的类型。这种罕见的实体通常是无症状的。但是,它们可能会长时间引起慢性非特异性症状,例如消化不良,慢性餐后疼痛,恶心,呕吐,博尔盖米,腹泻和便秘交替出现,体重减轻,贫血,脂肪泻或很少导致并发症,例如出血,阻塞,穿孔。阻塞可能是由于肠结石,粘连,肠套叠和肠扭转引起的。该病很难诊断,因为患者通常会出现模仿其他疾病的症状。对于临床医生而言,了解此实体很重要。在这里,我们介绍了一个多空肠憩室病例,在过去的20年中有反复发作的憩室炎病史,这些病例被误诊,现在由于相关节段的肠扭转以及围绕其轴的肠系膜而出现肠梗阻。空肠憩室段的切除是端对端空肠-空肠吻合术。自随访10个月以来,该患者无症状。

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