Jejunumda yerleþmiþ çok sayýda dev divertikülozis: Nadir görülen bir hastalýðýn nadir görülen bir klinik prezentasyonu

Jejuno-ileal divertiküllerde, duodenal divertiküllere kýyasla, genel komplikasyon geliþme riski dört kat, perforasyon riski 18 kat daha fazladýr. Asemptomatik olgularda rezeksiyon yapýlmazken, yaþamý tehdit eden komplikasyonlarda cerrahi müdahale gerekebilir. Bu olgu raporunda, uzun süredir var olan geçici semptomlarla baþvuran, çok sayýda dev jejunal divertikülü olan 69 yaþýnda bir erkek hasta sunuldu. Hastanýn 15 yýl önce geçirilmiþ apendektomi öyküsü mevcuttu. Son acil servis baþvurusunda çekilen kontrastlý batýn bilgisayarlý tomogafisinde, çok sayýda dev divertiküllü jejunum segmenti saptanmýþtý ve sonrasýnda açýk laparotomi ile eksize edilerek tedavi uygulanmýþtý. Hastanýn takiplerinde þikayetlerinin tekrarlamadýðý ve kilo almaya baþladýðý görüldü. Acil servise uzun süredir var olan karýn aðrýsý, kilo kaybý, þiþkinlik þikayetleri ile baþvuran ve özellikle batýn operasyonu geçmiþi bulunan hastalarda taný konulamadýðý zaman ayýrýcý tanýda jejunum kaynaklý divertiküllerin akýlda bulundurulmasýný öneriyoruz.

Multiple giant jejunal diverticulosis: A rare clinical presentation of a rarely encountered disease

Jejunoileal diverticula have a four-fold greater risk of developing general complications and an 18-fold greater risk of perforation compared to duodenal diverticula. While resection is not preferred in asymptomatic cases, surgical intervention may be required in life-threatening conditions. In this case report, a 69-year-old male patient with multiple giant jejunal diverticulum presenting with long-standing and transient symptoms was presented. The patient had a history of appendectomy 15 years before application. During the patient’s last admission to the emergency department, contrast-enhanced abdominal computed tomography was ordered and revealed jejunum segments with multiple giant diverticula which were treated by excision by open laparotomy. It was observed that the patient’s complaints did not recur and he started to gain weight. In patients admitted to the emergency department with complaints of long-standing abdominal pain, weight loss, and bloating, in whom diagnosis cannot be made, it is recommended to consider diverticulum originating from the jejunum in the differential diagnosis, especially in the presence of abdominal surgery history.