JEJUNOILEAL DIVERTICULOSIS. CLINICAL SIGNIFICANCE AND ITS COMPLICATIONS
Keywords:
Εκκολπώματα, νηστίδα, ειλεός, διάτρηση, εντερική απόφραξη,Abstract
Jejunoileal diverticulosis is an uncommon condition and proceeds unnoticed in the majority of patients. The reportcd incidence in the general population ranges from 0,02% to 7,1%. Most palients are asymtomatic, but 10-15% develop complications requiring surgical intervention.
The main clinical manifestations include vague abdominal symptoms, gastrointestinal bleeding and bacterial overgrowth syndrome. Small bowel resectio and anastomosis is indicated for the treatment of diverticulosis, bowel perforation and hemorrhage.
The high mortality of the acute complications is related to delayed diagnosis and the advanced age of the patients. Three new cases are presented.
References
Fisher ΜΗ. False diverticula of the intestine . J Exp Med 1900; 5: 333-352.
Herrington JL. Perforation of aquired diverticula of the jejunum and ileum. Surgery 1962;51:426-433.
Cooke WT, Cox ΕV, Fone DJ, Meynell MJ, Gaddie R. The clinical and metabolics significance of jejunaj divertcula. Gut 1963;4:115-131.
Case JT. Divertcula of small intestine other than Meckel's divertculum. JAMA 1920:75:1463-1470.
Shocket Ε, Simon S. Small bowel obstruction due to enterolith (bezoar) fermed in duodenal diνertculum: Α case report and reνiew of the literature. Am J Gastrenterol 1982;77:621-624.
Sibille Α, Willocx R. Jejunal diverticulitis. Am J Gastrenterol 1992;87:655-658.
Palder SB, Frey CB. Jejunal diverticulosis. Arch Surg 1988;123:889-894.
Rankin FW, Martin WJ. Diverticula of the small bowel. Αnn Surg 1934;100:1123- 1135.
Vieux U, Rao R, Diakoumakis EE, Keh W. Leiomyosarcoma in jejunal divertculum. Am J Gastrenterol 1985;80:858-861.
Α. Ν. Καψωριτάκης, Σ. Ποταμιάνος, I. Γραμματικάκης, Ν. Γκουρτσογιάννης, Η. Κουρούμαλης, Ο. Ν. Μανούσος. Εκκολπώματα νήστιδας - ειλεού. Περιγραφή τριών περιπτώσεων και ανασκόπηση βιβλιογραφίας. Ιατρική 1998;74(3):242-247.
Wilcox DR, Shatney HC. Surgical implications of jejunal diverticula. South Med J 1988;81:1386-1391.
Κrishnamurthy S, Kelly MM, Rohrmann CA, Schuffler MD. Jejunal diverticulosis: a heterogeneus disorder caused by a variety of abnormalitics of smooth muscle or myenleric plexus. Gastroenterology 1983;85:538-547.
Johnson GK, Soergel KH, Hensley GT, Dodds WJ, Hogan WJ. Cronkhite-Canada syndrome: gastrointestinal oathofhysiology and morhology. Gastroenterology 1972;63:140-152.
Salmoff IM, Schenk ΕΝ. Celiac disease and multiple jejunal diverticulosis. Am J Dig Dis 1967;12:189-197.
Friedman LS, Κirkham SE, Thistlethwaite JR, Platika D, Kolodny EH, Schuffer MD. Jejunal diverticulosis as a complication of Fabry's disease. Gastroenterology 1984;86:558-563.
Hirshowitz BI, Groll Α, Ceballos R . Hereditary nerνe deafness in three sisters with absent gastric motility, small bowel diverticulitis and ulceration and progressive sensory neuropathy. In : Bergsma D (ed) Birth defects: o riginal article series. Vol. 8, No 2. Baltimore, Williams and Wilkins, 1972:27-41.
Andersen LP, Schjoldager Β, Halver Β. Jejynal diverticulosis in a family. Scand J Gastroenterol 1988;23:672-674.
J8. Baskin RH, Mayo CW: Jejunal diverticulosis. Surg Clin North Am 1952;32:1185- 1196.
Altemeier WA, Bryant LR, Wulsin JH: The surgical significance of jejunal diverticulosis. Arch Surg 1963;86:732-745.
Κίng CE, Toskes ΡΡ. Small intestine bacterial overgrowth. Gastroenterology 1979;76:1035-1055
Clark TW, Horattas MC, Shorten SD. Jejunal diverticulosis: An uncommon entity with a common presentation. Surg Rounds 1994; Sept:553-556.
Scully RE, Mark EJ, McNeely WF, NcNeely BU. Case records of the
Massachussetts General Hospital. Ν Engl J Med 1990;322:1796-1806.
Ross CB, Richards WO, Sharp KW, Bertam PD, Schaper PW: Diverticular discase of the jejunum and its complications. Am Surg 1990;56:319-324.
L.M.Harris, C.M.Volpe, R.J. Doerr. Small bowel obstuction secondary to enterolith impaction complicating jejunal diverticulitis. Am J Gastroenterol 1997;92(9):1538-1540.
Ε. de Bree, Ε. Sanidas, Μ. Christodoulakis, J. Romanos, D. Tsiftsis. Jejunoileal diverticulosis and its complications. Dig Surg 1996;13:231-234.
Englund R, Jensen Μ: Acquired diverticulosis of the small intestine: Case reports and literature review. Aust NZ J Surg 1986;56:51-54.
Wilcox RD, Shatey CH: Massive rectal bleeding from jejunal diverticula. Surg Gynecol Obstet 1987;165:425-428.
Γρ. Κουράκλης, Ε. Κούσκος, Α. Παπαχριστοδούλου, Α. Γκλιβάνου, Χ. Παλούμπη, Μ. Σιαφολέας, Γ. Καρατζάς. Εκκολπώματα δωδεκαδακτύλου και λεπτού εντέρου. Ελληνική Χειρουργική 1999;71(6):542-546.
Brian JE Jr, Stair JM. Νοn colonic diverticular discase. Surg Gynecol Obstet 1985;161:189.
