title: Non-operative successful management of a perforated small bowel diverticulum.
abstract: Jejunoileal diverticula are rare and generally asymptomatic. In the few cases of patients who develop complications such as diverticulitis, perforation, obstruction, and/or hemorrhage, conventional treatment consists of surgical resection. We describe a case of perforated jejunoileal diverticulum with localized abscess and highlight the merits of surgical vs medical management. The patient is a 77-year-old male who presented with sharp, constant abdominal pain just inferior to the umbilicus. Administration of intravenous antibiotics results in complete and long-term resolution of the patient's symptoms. In this report, we establish a framework for safely treating perforated small bowel diverticulum without surgical exploration.
authors.affiliation: Melissa M Levack, Maria Lucia Madariaga, Haytham MA Kaafarani, Division of Trauma, Department of Surgery, Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Levack
authors.affiliation: Melissa M Levack, Maria Lucia Madariaga, Haytham MA Kaafarani, Division of Trauma, Department of Surgery, Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States.
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Madariaga
authors.affiliation: Melissa M Levack, Maria Lucia Madariaga, Haytham MA Kaafarani, Division of Trauma, Department of Surgery, Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States.
authors.forename: Haytham M A
authors.initials: HM
authors.lastname: Kaafarani
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000038:Abscess / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D061605:Administration, Intravenous; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004240:Diverticulum / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D007416:Intestinal Perforation / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D007579:Jejunal Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Abscess; Antibiotics; Diverticulitis; Jejunal diverticula; Small bowel perforation