Presentation
As a result of the variety of presentations, complications of jejunal diverticulosis present a diagnostic and therapeutic challenge for the acute care surgeon. [ncbi.nlm.nih.gov]
Entire Body System
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Anemia
A case of left-sided paraduodenal hernia and jejunal diverticulosis is described in 75-year-old man who presented with chronic intermittent abdominal pain, weight loss, and anemia. [ncbi.nlm.nih.gov]
As anemia was not improved by conservative therapy and selective superior mesenteric angiogram revealed a bleeding lesion in the jejunum, emergency operation was performed. [jlc.jst.go.jp]
Anemia due to iron deficiency and megaloblastic anemia have often been reported and commonly attributed to malabsorpion, steatorreia, and vitaminic deficit [23, 33]. [wjes.biomedcentral.com]
The disease is often asymptomatic and must be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain and discomfort. [mendeley.com]
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Painter
Burkitt DP, Walker AR, Painter NS. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet 1972;2:1408–11. [PubMed] [Google Scholar] 9. Heise CP. [ncbi.nlm.nih.gov]
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Turkish
[…] of Turkish conflict of laws. [turkiyeklinikleri.com]
Gastrointestinal
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Abdominal Pain
A 33-year man repeatedly presented to emergency with abdominal pain which resolved with analgesics until he developed constipation, vomiting, fever and severe abdominal pain. He had to undergo laparotomy which revealed multiple jejunal diverticula. [ncbi.nlm.nih.gov]
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Nausea
Jejunal diverticulosis is an uncommon condition, but it is often associated with a number of symptoms including postprandial abdominal pain, distension, flatulence, borborygmus, nausea, vomiting, diarrhea and constipation and with complications such as [ncbi.nlm.nih.gov]
During the 2 years before the current presentation, she had reported having frequent episodic nausea, abdominal distention, and colic followed by violent fecaloid vomiting. [nejm.org]
It is most often asymptomatic but presenting symptoms are nonspecific and include abdominal pain, nausea, diarrhea, malabsorption, bleeding, obstruction, and/or perforation. [utmb.influuent.utsystem.edu]
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Hematochezia
Figure 1 Case 3: A 62-year-old male on warfarin presented to the emergency department with melena and hematochezia. Neither EGD nor colonoscopy showed an active bleed. [journals.lww.com]
Diverticular bleeding manifests as painless hematochezia. Because the bleeding vessel is an arteriole, the amount of blood loss is usually moderate to severe. [merckmanuals.com]
[…] computed tomography (CT) angiography, CT enterography, and conventional angiography can also be used to delineate obscure sources of GIB. 1 Case Report A 63-year old woman was referred to our institution from a community hospital with a 3-day history of hematochezia [acgcasereports.gi.org]
A hemoglobin level is important in patients who report hematochezia. Electrolyte assays may be helpful in the patient who is vomiting or has diarrhea. Assess renal function prior to the administration of most intravenous contrast material. [emedicine.medscape.com]
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Abdominal Fullness
These findings include a sensation of vague or localized pain, rectal bleeding and abdominal fullness. [ncbi.nlm.nih.gov]
Vague and chronic, mainly post prandial, epigastric cramping pain, bloating or abdominal fullness is usually referred. [wjes.biomedcentral.com]
The disease often presents with non-specific symptoms like intermittent abdominal pain, dyspepsia, bloating or abdominal fullness, constipation, diarrhoea, malnutrition, anemia due to iron deficiency or megaloblastic anemia. [jovs.amegroups.com]
Workup
Workup of these symptoms included computed tomography, which showed small-bowel dilatation along with a whirl sign and numerous collateral veins, suggestive of a midgut volvulus (see video ). [nejm.org]
See Workup for more detail. Treatment of diverticulitis The management of patients with diverticulitis depends on their presentation severity, presence of complications, and comorbid conditions. [emedicine.medscape.com]
Serum
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Abnormal Renal Function
Her initial white cell count was 11.3 g/dL with an abnormal renal function-urea of 11.4 and a creatinine of 156. An initial ultrasound scan of the abdomen and pelvis was normal. [wjgnet.com]
Treatment
The treatment is mainly surgical; however, there have been cases where nonsurgical management was successful. [ncbi.nlm.nih.gov]
Prognosis
Prognosis The prognosis is good even with complications. [emedicine.medscape.com]
Course & Prognosis • 10-20% of patients experience complications, mainly diverticulitis and lower GI bleeding. • Conservative management of diverticular disease is preferred. • Surgery reserved for major complications. • In UK, surgery usually for cases [slideshare.net]
Telomere Length in Leukocyte DNA in Gastric Cancer Patients and its Association with Clinicopathological Features and Prognosis. [hospital.fujita-hu.ac.jp]
[…] gas and fluid into pelvis and peritoneal cavity abscess formation (seen in up to 30% of cases) may contain fluid, gas or both fistula formation (usually a chronic complication) gas in the bladder direct visualization of a fistulous tract Treatment and prognosis [radiopaedia.org]
Etiology
A 78-year-old man with bowel obstruction of unknown etiology was initially managed conservatively, but suffered recurrence of the obstruction. [ncbi.nlm.nih.gov]
A literature review has revealed that these signs have been present in other cases of jejunal diverticulosis, although the etiology and pathophysiology is not clearly understood. [paperity.org]
Epidemiology
A brief review of the epidemiology, pathogenesis, and clinical presentation displays the variety of symptoms associated with these rare conditions. [ncbi.nlm.nih.gov]
[citation needed] Epidemiology[edit] The prevalence of diverticulosis progressively increases with age. [en.wikipedia.org]
Systemic sclerosis Visceral myopathy Visceral neuropathy Epidemiology United States Duodenal diverticula are approximately five times more common than jejunoileal diverticula. [emedicine.medscape.com]
Pathophysiology
Pathophysiology, Diagnosis, Management, 2nd Ed. Philadelphia, Saunders, 1978, pp 1094–1103 Google Scholar 11. Ament ME, Shimoda SS, Saunders DR, et al: Pathogenesis of steatorrhea in three cases of small intestinal stasis syndrome. [springerlink.com]
A literature review has revealed that these signs have been present in other cases of jejunal diverticulosis, although the etiology and pathophysiology is not clearly understood. [paperity.org]
// British Medical Journal;7/26/1980, Vol. 281 Issue 6235, p273 Diarrhoea is occasionally encountered during cimetidine treatment but no satisfactory pathophysiological mechanism has been proposed. [connection.ebscohost.com]
Pathophysiology The cause of this condition is not known. It is believed to develop as the result of abnormalities in peristalsis, intestinal dyskinesis, and high segmental intraluminal pressures. [emedicine.medscape.com]
"Etiology and pathophysiology of diverticular disease". Clinics in Colon and Rectal Surgery. 17 (3): 147–53. doi:10.1055/s-2004-832695. PMC 2780060. PMID 20011269. [en.wikipedia.org]
Prevention
Because jejunal diverticula may be encountered during a sonographic examination, sonologists should be aware of their sonographic appearance to prevent diagnostic errors. [ncbi.nlm.nih.gov]
Because jejunal diverticula may be encountered during a sonographic examination, sonologists should be aware of their sonographic appearance to prevent diagnostic errors. 2006 Wiley Periodicals, Inc. [onlinelibrary.wiley.com]
Early diagnosis and proper management is important to prevent morbidity. Diagnostic modalities that are helpful include abdominal CT or MRI, capsule endoscopy, and deep enteroscopy. The American College of Gastroenterology 2016. All Rights Reserved. [journals.lww.com]