Case Report
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World J Gastroenterol. Dec 28, 2014; 20(48): 18477-18479
Published online Dec 28, 2014. doi: 10.3748/wjg.v20.i48.18477
Non-operative successful management of a perforated small bowel diverticulum
Melissa M Levack, Maria Lucia Madariaga, Haytham MA Kaafarani
Melissa M Levack, Maria Lucia Madariaga, Haytham MA Kaafarani, Division of Trauma, Department of Surgery, Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
Author contributions: All three authors contributed to the conception, data collection, write-up and critical revision of the manuscript; all authors approved of the final version to be published.
Correspondence to: Haytham MA Kaafarani, MD, MPH, Division of Trauma, Department of Surgery, Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge St Suite 810, Boston, MA 02114, United States. hkaafarani@mgh.harvard.edu
Telephone: +1-617-6432433 Fax: +1-617-7269121
Received: May 15, 2014
Revised: June 13, 2014
Accepted: July 15, 2014
Published online: December 28, 2014
Abstract

Jejunoileal diverticula are rare and generally asymptomatic. In the few cases of patients who develop complications such as diverticulitis, perforation, obstruction, and/or hemorrhage, conventional treatment consists of surgical resection. We describe a case of perforated jejunoileal diverticulum with localized abscess and highlight the merits of surgical vs medical management. The patient is a 77-year-old male who presented with sharp, constant abdominal pain just inferior to the umbilicus. Administration of intravenous antibiotics results in complete and long-term resolution of the patient’s symptoms. In this report, we establish a framework for safely treating perforated small bowel diverticulum without surgical exploration.

Keywords: Jejunal diverticula, Diverticulitis, Small bowel perforation, Antibiotics, Abscess

Core tip: Perforated jejunal diverticulum can be safely managed without surgical exploration in carefully selected patients.