2017 Volume 37 Issue 1 Pages 085-089
A 65-year-old woman visited another hospital with a history of abdominal pain. As a plain abdominal X-ray showed free air in the abdomen and abdominal CT scan showed evidence of perforation and peritonitis, the patient was transferred to our hospital for emergency operation. Physical examination revealed tenderness in the left lower quadrant. Laboratory data were consistent with an inflammatory process；the white blood cell count was 4,700/μL and the serum C-reactive protein level was 37.21mg/dL. Abdominal CT showed perforation of the proximal jejunum, with free air and a fluid collection around the perforation. We performed emergency laparotomy for proximal jejunal perforation. Intraoperatively, the jejunal perforation was seen 10 cm distal to the ligament of Treitz. We performed jejunal resection with duodeno-jejunal anastomosis (side-to-side) for reconstruction. The histopathological diagnosis was perforation of a pseudo-diverticulum in the proximal jejunum. The patient's postoperative course was uneventful.
