Small Intestinal Intussusception Due to Complicated Giant Jejunal Diverticulosis

Medicina (Kaunas). 2021 Jan 28;57(2):116. doi: 10.3390/medicina57020116.

Abstract

Background: Jejunal diverticulosis and jejunal lipomatosis are uncommon conditions. Usually asymptomatic, they may cause severe complications in some cases. Intussusception is unusual in adults, but when diagnosed swiftly it can be treated surgically, usually with good outcome. Case presentation: We present a 60-year-old female patient with a history of chronic malnutrition and anemia, complaining of acute abdominal pain, vomiting and diarrhea. Contrast-enhanced abdominal computed tomography (CT) showed intussusception, multiple giant jejunal diverticula and multiple lipomas. The patient underwent urgent surgery, but radical treatment was not possible due to the extent of the diseases. One month later, another surgery was needed due to ileostomy obstruction caused by lipomas. The patient's condition deteriorated due to malnutrition and concomitant metabolic disorders, which eventually led to her demise. Conclusions: Radical treatment is not always possible in an extensive jejunal disease. Prolonged malnutrition impairs postoperative healing, and therefore surgical or nutritional treatment should be considered in jejunal diverticulosis before the onset of severe complications requiring urgent surgical intervention.

Keywords: abdominal surgery; diverticulosis; intussusception; jejunum; lipoma; malnutrition; visceral surgery.

Publication types

  • Case Reports

MeSH terms

  • Diverticulum* / complications
  • Diverticulum* / diagnostic imaging
  • Diverticulum* / surgery
  • Female
  • Humans
  • Intestine, Small
  • Intussusception* / diagnosis
  • Intussusception* / diagnostic imaging
  • Jejunal Diseases* / complications
  • Jejunal Diseases* / diagnostic imaging
  • Jejunum / surgery
  • Middle Aged