Abstract
A 91-year-old woman was admitted to our hospital with hypogastric pain. Three months earlier, she had been suspected with infectious enteritis. Drug-induced enteritis subsequently occurred, and she was treated for 2 months in hospital. On examination, systemic inflammatory response syndrome was identified. Muscular defense was detected on abdominal examination. Blood studies showed evidence of severe inflammatory response. Computed tomography showed massive free air and fluid in the abdominal cavity and mucous membrane stoppage of the small intestine. Based on a diagnosis of perforation of the small intestine, emergent surgery was performed. In the abdominal cavity, a massive volume of dirty ascites was seen. Perforation of a jejunal diverticulum was identified 50 cm from the ligament of Treitz. Many jejunal diverticula were seen in this area. Enterectomy and diverticulum turnover were performed. Postoperatively, the patient was managed in the intensive care unit. As her condition improved, she was transferred to another hospital 47 days postoperatively to improve swallowing function. In older patients who complain of non-specific digestive symptoms, keeping the possibility of small intestinal diverticulitis in mind is important to prevent severe complications.
