Objectives Perforated jejunal diverticulitis (PJD) is rare, but it has high mortality rates. The role of nonsurgical management is debated. The aim of this study is to assess the outcomes of medical and surgical management of PJD. Patients and methods A single-centre study on a series of emergency patients diagnosed with PJD between 2010 and 2016 was conducted. Results Eleven patients with PJD were treated (seven women). Nine out of 11 were diagnosed by a computed tomography scan, and two were diagnosed at laparotomy. The initial approach was medical treatment in five patients, based on clinical and imaging findings. Four (80%) of these five patients were discharged without the need for surgical intervention. The median hospital stay was 7.5 days. Seven patients required surgery overall with a median length of hospital stay of 10.8 days. Surgical procedures consisted of segmental bowel resection and primary anastomosis in six patients and simple closure in one. There was no perioperative deaths. One patient required percutaneous drainage because of anastomotic leak, and one required reoperation owing to evisceration. Discussion Selected patients with PJD can be successfully managed with conservative approach, based on clinical and computed tomography findings.

Short article: Outcome of medical and surgical management for perforated jejunal diverticulitis

Pellino, Gianluca;
2019

Abstract

Objectives Perforated jejunal diverticulitis (PJD) is rare, but it has high mortality rates. The role of nonsurgical management is debated. The aim of this study is to assess the outcomes of medical and surgical management of PJD. Patients and methods A single-centre study on a series of emergency patients diagnosed with PJD between 2010 and 2016 was conducted. Results Eleven patients with PJD were treated (seven women). Nine out of 11 were diagnosed by a computed tomography scan, and two were diagnosed at laparotomy. The initial approach was medical treatment in five patients, based on clinical and imaging findings. Four (80%) of these five patients were discharged without the need for surgical intervention. The median hospital stay was 7.5 days. Seven patients required surgery overall with a median length of hospital stay of 10.8 days. Surgical procedures consisted of segmental bowel resection and primary anastomosis in six patients and simple closure in one. There was no perioperative deaths. One patient required percutaneous drainage because of anastomotic leak, and one required reoperation owing to evisceration. Discussion Selected patients with PJD can be successfully managed with conservative approach, based on clinical and computed tomography findings.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11591/402324
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