2025 Volume 45 Issue 1 Pages 1-4
Diverticular perforation of the small intestine, while relatively rare, can be life-threatening and should be kept in mind in the differential diagnosis of acute abdomen. We have encountered seven cases of perforated small intestinal diverticulum at our hospital until date, and reviewed their clinicopathological characteristics. The patients included 3 men and 4 women, with an average age of 73.7 years. All the patients presented with the complaint of abdominal pain, but the pain tended to be milder in patients who visited the hospital more than a week after the symptom onset. There were no cases with shock vitals before surgery. The diagnosis of perforation of the small intestine was made preoperatively in 4 cases, even though the exact site of perforation could not be identified on the images. Intraoperatively, 5 patients had perforation of a jejunal diverticulum, located in each case within 110 cm of the Treitz ligament, and 2 patients had diverticular perforation in the terminal ileum. All patients underwent partial resection of the perforated intestinal segment, and none showed any perioperative complications. From our experience, perforated small intestinal diverticula appear to be less deadly than they used to be, presumably because of recent improvements in diagnostic imaging techniques and in perioperative systemic management.
