Successful management of perforated duodenal diverticulitis with intra-abdominal drainage and feeding jejunostomy: a case report and literature review

Kaohsiung J Med Sci. 2008 Aug;24(8):425-9. doi: 10.1016/S1607-551X(08)70167-0.

Abstract

We report the clinical experience of one patient with perforated duodenal diverticulitis who was successfully treated by intra-abdominal drainage and feeding jejunostomy. A 53-year-old male patient visited our hospital due to acute onset of abdominal pain and distension. Physical examination revealed tenderness over the epigastric area and right-lower quadrant of the abdomen without obvious rebound tenderness or muscle guarding. Duodenal diverticulitis with a retroperitoneal abscess was identified by abdominal computed tomography scan. Surgical intervention was performed after the failure of conservative treatment. The operative findings were compatible with perforated duodenal diverticulitis, and intra-abdominal drainage of retroperitoneal abscess with simultaneous feeding jejunostomy was undertaken. The patient was doing well at the 4-month postoperative follow-up visit. We suggest the use of a conservative operative method, as opposed to conventional diverticulectomy and duodenorrhaphy, as an alternative approach for the management of this disorder, especially when conservative treatment has failed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdomen / surgery*
  • Diverticulitis / diagnostic imaging
  • Diverticulitis / surgery
  • Diverticulitis / therapy*
  • Drainage*
  • Duodenum / diagnostic imaging
  • Enteral Nutrition
  • Follow-Up Studies
  • Humans
  • Intestinal Perforation / diagnostic imaging
  • Intestinal Perforation / surgery
  • Intestinal Perforation / therapy*
  • Jejunostomy
  • Male
  • Middle Aged
  • Radiography
  • Tomography Scanners, X-Ray Computed