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Introduction
Small bowel diverticular disease is uncommon, representing 1–2% of general population. The ileum diverticulum is very rare, especially if it is complicated by enterocutaneous fistula with abdominal wall abscess.
Presentation of the case
Here, we report a case of small bowel diverticulum, ileum diverticulum with enterocutaneous fistula...
Citations
... A comprehensive patient history must be obtained to rule out other conditions such as appendicitis, cholecystitis, colonic diverticulitis, pancreatitis, bowel obstruction, or foreign body perforation [3,4,[8][9][10][11][12][13][14][15][16][17][18][19][20]24,34]. An abdominal X-ray can help detect perforation or obstruction but cannot establish a diagnosis on its own. ...
Small bowel non-Meckelian diverticulosis is a rare condition with only a few published cases despite being described over 200 years ago. In the midst of the COVID-19 pandemic, studies suggested that many patients may experience gastrointestinal manifestations. Intestinal symptoms could worsen the inflammation and infection associated with small bowel diverticulitis. Here we present three cases: one with inflammation and rupture in a COVID-19 patient and another as an asymptomatic detection. The third case involved recurrence after the first laparoscopic lavage approach. Furthermore, we provide a mini-review of the literature to emphasize the importance of considering this entity in the differential diagnosis of an acute abdomen. In the majority of cases involving small bowel diverticula, conservative management is the preferred approach. However, when complications arise, surgical intervention, including enteroctomy and primary anastomosis, may be necessary to achieve optimal outcomes.
... 7 lead to gut inflammation and exacerbation of inflammatory bowel diseases, causing negative effects that can worsen the disease severity in both the short and long term [9]. A comprehensive patient history must be obtained to rule out other conditions such as appendicitis, cholecystitis, colonic diverticulitis, pancreatitis, bowel obstruction, or foreign body perforation [3,4,[8][9][10][11][12][13][14][15][16][17][18][19][20]24,34]. An abdominal X-ray can help detect perforation or obstruction but cannot establish a diagnosis on its own. ...
Small bowel non-Meckelian diverticulosis is a rare condition with only few published cases despite being described over 200 years ago. In the midst of the COVID-19 pandemic, studies suggested that a lot of patients may experience gastrointestinal manifestations. Intestinal symptoms could worsen the inflammation and infection associated with small bowel diverticulitis. Here, we present two cases: one with inflammation and rupture in a COVID-19 patient and the other as an asymptomatic detection. Furthermore, we provide a mini-review of the literature to emphasize the importance of considering this entity in the differential diagnosis of an acute abdomen.
... [1] Small intestinal diverticulum, a rare condition with an incidence of 1-2%, is usually asymptomatic and often diagnosed incidentally. [1,2] Furthermore, jejunoileal diverticula are far less common than duodenal ones. [3] While resection is not preferred in asymptomatic cases, surgical intervention may be required in patients with life-threatening conditions caused by diverticula, such as intestinal obstruction, perforation, bleeding, and abscess. ...
... [1] In the small intestine, they are most commonly diagnosed in the duodenum, followed by the jejunum (albeit very rarely) and often in the 6 th and 7 th decades. [2,6] Many of these cases are considered to be acquired forms of disease. [2] The incidence of jejunoileal diverticulosis ranges from 0.03% to 8.0% in autopsy series and from 0.02% to 7% in contrast-enhanced radiological studies. ...
... [2,6] Many of these cases are considered to be acquired forms of disease. [2] The incidence of jejunoileal diverticulosis ranges from 0.03% to 8.0% in autopsy series and from 0.02% to 7% in contrast-enhanced radiological studies. [6,7] Jejunal diverticula usually occur at proximal sites and are mostly multiple; [1] nonetheless, multiple large jejunal diverticulum have been reported extremely rarely. ...
Jejunoileal diverticula have a four-fold greater risk of developing general complications and an 18-fold greater risk of perforation compared to duodenal diverticula. While resection is not preferred in asymptomatic cases, surgical intervention may be required in life-threatening conditions. In this case report, a 69-year-old male patient with multiple giant jejunal diverticulum presenting with long-standing and transient symptoms was presented. The patient had a history of appendectomy 15 years before application. During the patient's last admission to the emergency department, contrast-enhanced abdominal computed tomography was ordered and revealed jejunum segments with multiple giant diverticula which were treated by excision by open laparotomy. It was observed that the patient's complaints did not recur and he started to gain weight. In patients admitted to the emergency department with complaints of long-standing abdominal pain, weight loss, and bloating, in whom diagnosis cannot be made, it is recommended to consider diverticulum originating from the jejunum in the differential diagnosis, especially in the presence of abdominal surgery history.
Introduction:
We report a rare case of abdominal wall abscess caused by ileal diverticulitis that developed along the midline below the umbilicus and resembled a urachal carcinoma.
Case presentation:
A 76-year-old woman with diabetes presented with abdominal enlargement below the umbilicus. Computed tomography revealed a well-enhanced mass, which was visualized on magnetic resonance imaging as a continuous mass connected to the restiform structure, extending from the umbilicus to the bladder. As the mass showed high uptake on 18F-fluorodeoxyglucose positron emission tomography, urachal carcinoma was suspected, and surgery was subsequently performed. As the tumor adhered to the ileum, partial resection of the small intestine was required. The pathological diagnosis was abdominal wall abscess associated with ileal pseudodiverticulitis.
Conclusion:
Although abdominal wall abscess caused by ileal diverticulitis is rare, it should be considered as a differential diagnosis of urachal carcinoma.
There have been six reported cases of jejunoileal diverticulitis causing an abdominal wall abscess. To the best of our knowledge, this is the first case of jejunal diverticulitis complicated with abdominal wall fistula and iliac bone osteomyelitis. In this video, we present robotic management of a complicated case of jejunal diverticulitis complicated with abdominal wall fistula and iliac bone osteomyelitis.
