Multiple Small Bowel Diverticula Were an Unexpected Finding During Laparoscopic Enterectomy for Crohn's Disease.
Crohn’s disease
case report
magnetic resonance enterography
small intestine diverticulosis
Journal
Medical archives (Sarajevo, Bosnia and Herzegovina)
ISSN: 1986-5961
Titre abrégé: Med Arch
Pays: Bosnia and Herzegovina
ID NLM: 101635337
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
entrez:
25
6
2020
pubmed:
25
6
2020
medline:
28
4
2021
Statut:
ppublish
Résumé
Small bowel diverticulosis (SBD) is a rare entity. Although it is usually an asymptomatic condition, clinical manifestations may vary from non-specific clinical signs to severe and complicated disease. The coexistence of SBD and Crohn's disease (CD) is rarely reported in the current literature. We present a rare case of concomitant Crohn's disease (CD) and SBD in a male patient, where multiple jejunal diverticula were an incidental intraoperative finding. Preoperative evaluation with magnetic resonance enterography (MRE) failed to recognize the coexistence of these two entities. Surgeons should be aware of the possibility of this rare situation. A 52-year-old Caucasian male diagnosed with CD was referred to our department for surgical intervention due to an ileal stricture. The patient reported no past medical history, except for a few episodes of bloody diarrhoea during a three-year period. The index colonoscopy revealed luminal narrowing in the ileum at approximately 70 cm proximal to the ileocaecal valve, and biopsies revealed findings compatible with CD. Clinical examination and laboratory tests were unremarkable one day before surgery. The patient underwent laparoscopic segmental resection of the affected part of the ileum. Intraoperatively, multiple non-inflamed diverticula along the jejunum extending from the Treitz ligament to the proximal ileum were recognized. Our patient had an uncomplicated post-operative course and was discharged on the fifth post-operative day. Pathological examination revealed features compatible with CD in the active phase. The patient was referred to his gastroenterological team for further consultation regarding the appropriate post-operative management. Concomitant CD and SBD is a rare condition, and the differential diagnosis may be challenging due to overlapping symptoms.
Identifiants
pubmed: 32577058
doi: 10.5455/medarh.2020.74.142-145
pmc: PMC7296412
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
142-145Informations de copyright
© 2020 Ira Sotirova, Antonios Gklavas, Dimitra Papalouka, Sofia Gourtsoyianni, Dimitrios Christodoulou, Ioannis Papaconstantinou.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest.
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