A case of perforation of ileal diverticula with multiple diverticulosis of the small intestine

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  • KOAMI Hiroyuki
    Department of Surgery, Center for Gastroenterology, Urasoe General Hospital
  • MATSUMURA Toshinobu
    Department of Surgery, Center for Gastroenterology, Urasoe General Hospital
  • KAMEYAMA Shinichiro
    Department of Surgery, Center for Gastroenterology, Urasoe General Hospital
  • ISHIMINE Tomonari
    Department of Surgery, Center for Gastroenterology, Urasoe General Hospital
  • ISA Tsutomu
    Department of Surgery, Center for Gastroenterology, Urasoe General Hospital

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  • 回腸憩室穿通により緊急手術を要した小腸多発憩室症の1例
  • 症例 回腸憩室穿通により緊急手術を要した小腸多発憩室症の1例
  • ショウレイ カイチョウ ケイシツセンツウ ニ ヨリ キンキュウ シュジュツ オ ヨウシタ ショウチョウ タハツ ケイシツショウ ノ 1レイ

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Abstract

A 63-year-old man presented to our emergency department with the chief complaint of right flank pain for 3 days. Abdominal CT revealed an ileocecal abscess with extraintestinal gas and mutiple diverticulum. Emergency ileocecal resection was performed based on the diagnosis of panperitonitis and revealed an ileocecal abscess with purulent ascites. Moreover, there were 9 jejunum diverticula located 10-70 cm from the ligament of Treitz, but no resection was performed because there was no sign of infection or perforation. The specimen revealed an ileocecal abscess due to perforation of the ileal diverticulum which was diagnosed as a true diverticulum by histopathological analysis. The patient was discharged on the 13th postoperative day. Perforation or penetration of the ileal diverticulum is rare and is difficult to diagnose in the emergency room. As the prognosis is poor for patients with perforation, emergency laparotomy should be considered at an early stage for suspicious cases.

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