title: Jejuno-ileal diverticulitis: Etiopathogenicity, diagnosis and management.
abstract: BACKGROUND
  Although diverticular disease of the duodenum and colon is frequent, the jejuno-ileal diverticulosis (JOD) is an uncommon entity. The perforation of the small bowel diverticula can be fatal due to the delay in diagnosis.
  
  
  METHODS
  We report the case of a 79-year-old man presenting with generalized abdominal pain and altered bowel habits. Physical examination revealed a severe diffuse abdominal pain. A CT scan of the abdomen and pelvis with oral contrast showed thickening of the distal jejunal loop and thickening and infiltration of the mesenteric fat and the presence of free air in the mesentery suggesting a possible perforation adjacent to the diverticula. A midline laparotomy was performed. The jejunal diverticula were found along the mesenteric border. Forty centimeters of the jejunum were resected. Histopathology report confirmed the presence of multiple jejunual diverticula, and one of them was perforated. The patient tolerated the procedure and the postoperative period was uncomplicated.
  
  
  CONCLUSIONS
  The prevalence of small intestinal diverticula ranges from 0.06% to 1.3%. The etiopathogenesis of JOD is unclear, although the current hypothesis focuses on abnormalities in the smooth muscle or myenteric plexus, on intestinal dyskinesis and on high intraluminal pressures. Diagnosis is often difficult and delayed because clinical symptoms are not specific and mainly imaging studies performs the diagnosis.
  
  
  CONCLUSIONS
  Because of the relative rarity of acquired jejuno-ileal diverticulosis, the perforation of small bowel diverticulitis poses technical dilemmas.
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France. Electronic address: Radwankassir42@hotmail.Fr.
authors.forename: Radwan
authors.initials: R
authors.lastname: Kassir
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Alexia
authors.initials: A
authors.lastname: Boueil-Bourlier
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Sylviane
authors.initials: S
authors.lastname: Baccot
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Abboud
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Joelle
authors.initials: J
authors.lastname: Dubois
authors.affiliation: Department of Pathology, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Carmen Adina
authors.initials: CA
authors.lastname: Petcu
authors.affiliation: Department of Radiology, CHU Hospital, Jean Monnet University, Saint Etienne, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Boutet
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Ugo
authors.initials: U
authors.lastname: Chevalier
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Mathias
authors.initials: M
authors.lastname: Montveneur
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Marie-Isabelle
authors.initials: MI
authors.lastname: Cano
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Ferreira
authors.affiliation: Department of General Surgery, CHU Archet 2, Nice University, Nice, France.
authors.forename: Tarek
authors.initials: T
authors.lastname: Debs
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Tiffet
keywords: Acute abdomen; Perforation; Small bowel diverticulum; Surgery
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