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DOI: 10.1055/s-0038-1675433
Small Bowel Diverticulosis Causing Pneumoperitoneum without Peritonitis: A Case Report
Publication History
Received: 31 August 2018
Accepted after revision: 05 September 2018
Publication Date:
18 June 2019 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00043197/201801/lookinside/thumbnails/10-1055-s-0038-1675433_00013-1.jpg)
Abstract
Small bowel diverticulosis is a rare finding, with varied clinical presentations, which make the diagnosis difficult and delayed. Many cases are asymptomatic. However, it is an entity that can present with fatal complications. Here, we present a case of a 79-year-old male patient with diffuse small bowel diverticulosis, who presented with loose stools and acute exacerbation of chronic abdominal pain. Plain abdominal X-ray showed dilated bowel loops and pneumoperitoneum, which raised the possibility of bowel perforation. Computed tomography images revealed diffuse small bowel diverticulosis and pneumoperitoneum. Subsequent explorative laparotomy revealed no bowel perforation. Small bowel diverticulosis is a well-known cause of chronic/recurrent pneumoperitoneum without peritonitis or surgery.
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References
- 1 Ja'afreh S, Odeh J. Complicated diffuse giant small bowel diverticulosis: a case report. J Royal Med Serv 2013; 20: 71-75
- 2 Tsiotos GG, Farnell MB, Ilstrup DM. Nonmeckelian jejunal or ileal diverticulosis: an analysis of 112 cases. Surgery 1994; 116 (04) 726-731 discussion 731–732
- 3 Akhrass R, Yaffe MB, Fischer C, Ponsky J, Shuck JM. Small-bowel diverticulosis: perceptions and reality. J Am Coll Surg 1997; 184 (04) 383-388
- 4 Wilcox RD, Shatney CH. Surgical implications of jejunal diverticula. South Med J 1988; 81 (11) 1386-1391
- 5 Dunn V, Nelson JA. Jejunal diverticulosis and chronic pneumoperitoneum. Gastrointest Radiol 1979; 4 (02) 165-168
- 6 Kwak JY, Park EH, Park CS, Kim JH, Han MS, Kwak JH. Uncomplicated jejunal diverticulosis with pneumoperitoneum. Ann Surg Treat Res 2016; 90 (06) 346-349
- 7 Alvarez Jr J, Dolph J, Shetty J, Marjani M. Recurrent rupture of jejunal diverticula. Conn Med 1982; 46 (07) 376-378
- 8 Longo WE, Vernava III AM. Clinical implications of jejunoileal diverticular disease. Dis Colon Rectum 1992; 35 (04) 381-388
- 9 Falidas E, Vlachos K, Mathioulakis S, Archontovasilis F, Villias C. Multiple giant diverticula of the jejunum causing intestinal obstruction: report of a case and review of the literature. World J Emerg Surg 2011; 6 (01) 8
- 10 Ferreira-Aparicio FE, Gutiérrez-Vega R, Gálvez-Molina Y, Ontiveros-Nevares P, Athie-Gútierrez C, Montalvo-Javé EE. Diverticular disease of the small bowel. Case Rep Gastroenterol 2012; 6 (03) 668-676
- 11 Kouraklis G, Glinavou A, Mantas D, Kouskos E, Karatzas G. Clinical implications of small bowel diverticula. Isr Med Assoc J 2002; 4 (06) 431-433
- 12 Krishnamurthy S, Kelly MM, Rohrmann CA, Schuffler MD. Jejunal diverticulosis. A heterogenous disorder caused by a variety of abnormalities of smooth muscle or myenteric plexus. Gastroenterology 1983; 85 (03) 538-547
- 13 Rankin FW, Martin Jr WJ. Diverticula of the small bowel. Ann Surg 1934; 100 (06) 1123-1135
- 14 Altemeier WA, Bryant LR, Wulsin JH. The surgical significance of jejunal diverticulosis. Arch Surg 1963; 86: 732-745
- 15 Palder SB, Frey CB. Jejunal diverticulosis. Arch Surg 1988; 123 (07) 889-894
- 16 Rodriguez HE, Ziauddin MF, Quiros ED, Brown AM, Podbielski FJ. Jejunal diverticulosis and gastrointestinal bleeding. J Clin Gastroenterol 2001; 33 (05) 412-414
- 17 Butler JS, Collins CG, McEntee GPC. Perforated jejunal diverticula: a case report. J Med Case Reports 2010; 4: 172
- 18 Ross CB, Richards WO, Sharp KW, Bertram PD, Schaper PW. Diverticular disease of the jejunum and its complications. Am Surg 1990; 56 (05) 319-324
- 19 Herrington Jr JL. Perforation of acuired diverticula of the jejunum and ileum. Analysis of reported cases. Surgery 1962; 51: 426-433
- 20 Nanson EM, Dragan GE. A spontaneous pneumoperitoneum due to jejunal diverticulosis. Ann Surg 1956; 143 (01) 112-116