Tripurari Mishra, MD1, Shanu N Kothari, MD2. 1Gundersen Medical Foundation, 2Gundersen Health System
Jejunoileal diverticula are present in 1% of the population. The majority of diverticula (80%) occur in the jejunum along the mesenteric border of the small bowel. They generally lack a true muscular layer and are considered acquired. The cause is unknown but there is a possible association with dysmotility. It is diagnosed with UGI or CT scan with oral contrast. We present the case of a 69-year-old female who presented with abdominal pain and a white blood cell count of 21,000. A CT scan was obtained with oral contrast and intraabdominal abscess was noted around the proximal jejunum. The patient was placed on antibiotics and a percutaneous drain was placed for source control. Subsequently, an UGI confirmed presence of jejunal diverticula and a sinogram confirmed the presence of a fistula. Once the inflammation subsided, the patient was scheduled for a laparoscopic resection of jejunal diverticula 8 weeks after resolution of her symptoms. A laparoscopic approach was utilized and the jejunal diverticula were carefully dissected free of the adhesions. Forty cm of proximal jejunum containing diverticula was resected and a side-to-side anastomosis was performed. Leak test was negative using an endoscope. The patient recovered without complications and was discharged on postoperative day 4. Laparoscopic resection of complex jejunal diverticulitis is safe and feasible.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94625
Program Number: V112
Presentation Session: Colorectal Videos II
Presentation Type: Video