title: A Retrospective, Unicentric Evaluation of Complicated Diverticulosis Jejuni: Symptoms, Treatment, and Postoperative Course.
abstract: BACKGROUND
  In contrast to the diverticulosis of the colon, jejunal diverticulosis is a rare condition. The incidence is 0.06-5% in large autopsy series. Complicated diverticulosis jejuni (CDJ) often presents with unspecific symptoms. Therefore, diagnosis is often a challenging process and due to the clinical rarity generally valid recommendation of perioperative management does not exist.
  
  
  METHODS
  We considered only patients who were operated in our center between April 2007 and August 2014. Patients were identified by data bank search via International Statistical Classification of Diseases and Related Health Problems diagnosis code K57.10. Data were manually screened, and patients with Meckel's and duodenal diverticula were excluded from this study. Eleven consecutive patients with CDJ were finally included in this study. We analyzed symptoms, diagnostic procedures, surgical treatment, and postoperative morbidity and mortality.
  
  
  RESULTS
  The median age of our patients was 76 years (range: 34-87). CDJ presented most frequently as intestinal bleeding or as diverticulitis. Clinical symptoms were unspecific abdominal pain, hematemesis or melena, ileus, nausea, and emesis as well as patients with acute abdomen. Esophagogastroduodenoscopies confirmed CDJ in two of the three patients. An abdominal computed tomography scan only helped to diagnose CDJ in two of the 10 patients. Eight (72.7%) patients received an open segmental resection with primary anastomosis. In three (27.3%) cases, a reoperation was necessary. Overall morbidity rate was 45.5%, and perioperative mortality was 9.1%.
  
  
  CONCLUSIONS
  Due to the acute character of the disease, patients with CDJ are seriously ill. To diagnose patients with CDJ remains challenging as diagnostic investigations are usually not helpful in confirming the diagnosis. Still, diagnosis of CDJ is most frequently confirmed intraoperatively.
authors.affiliation: Department of Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University , Mannheim , Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Téoule
authors.affiliation: Department of Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University , Mannheim , Germany.
authors.forename: Emrullah
authors.initials: E
authors.lastname: Birgin
authors.affiliation: Department of Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University , Mannheim , Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Zaltenbach
authors.affiliation: Department of Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University , Mannheim , Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Kähler
authors.affiliation: Department of Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University , Mannheim , Germany.
authors.forename: Torsten J
authors.initials: TJ
authors.lastname: Wilhelm
authors.affiliation: Department of Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University , Mannheim , Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Kienle
authors.affiliation: Department of Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University , Mannheim , Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Rückert
keywords: acute abdomen; complicated jejunal diverticulitis; perioperative management; rare disease; visceral surgery