A Case of Perforation of Multiple True Diverticula

Abstract

Diverticulosis of the small intestine is a relatively rare form of gastrointestinal diverticulosis and is often asymptomatic. There are many reports that preoperative diagnosis of perforation of a small intestinal diverticulum was difficult, but the course was good after surgery. The case of a 97-year-old woman, who lived in a facility, who had a good course after surgical treatment for small intestinal diverticulum perforation, is presented. She was diagnosed with dementia in her hometown and was treated with observation on an ambulatory basis. She was referred to our hospital with chief complaints of abdominal pain and coldness. Her vital signs were normal. The symptoms were not clear. Blood tests showed WBC 2,800/μl and CRP 0.11 mg/dl. Contrast-enhanced computed tomography (CT) showed free air, diverticular perforation of the small intestine was suspected, and emergency surgery was performed. Multiple diverticula were found in the small intestine, and abscess formation was found 70 cm from Treitz's ligament to the anal side. The diagnosis was small intestinal diverticular perforation, and she was treated by partial resection of the small intestine. The histopathological diagnosis was a perforated true diverticulum of the small intestine. Her postoperative course was good, and she was discharged from the hospital on postoperative day 39.