title: Flare-Up Diverticulitis in the Terminal Ileum in Short Interval after Conservative Therapy: Report of a Case.
abstract: Diverticulitis in the terminal ileum is uncommon. Past reports suggested that conservative therapy may be feasible to treat terminal ileum diverticulitis without perforation; however, there is no consensus on the therapeutic strategy for small bowel diverticulitis. We present a 37-year-old man who was referred to our hospital for sudden onset of abdominal pain and nausea. He was diagnosed with diverticulitis in the terminal ileum by computed tomography (CT). Tazobactam/piperacillin hydrate (18 g/day) was administered. The antibiotic treatment was maintained for 7 days, and the symptoms disappeared after the treatment. Thirty-eight days after antibiotic therapy, he noticed severe abdominal pain again. He was diagnosed with diverticulitis in terminal ileum which was flare-up of inflammation. He was given antibiotic therapy again. Nine days after antibiotic therapy, laparoscopy assisted right hemicolectomy and resection of 20 cm of terminal ileum were performed. Histopathology report confirmed multiple ileal diverticulitis. He was discharged from our hospital 12 days after the surgery. Colonoscopy was performed two months after the surgery and it revealed no finding suggesting inflammatory bowel disease. Surgical treatment should be taken into account as a potential treatment option to manage the diverticulitis in the terminal ileum even though it is not perforated.
authors.affiliation: Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi Yokosuka City, Kanagawa 238-8567, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Nakatani
authors.affiliation: Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi Yokosuka City, Kanagawa 238-8567, Japan; Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama 330-8503, Japan.
authors.forename: Takaharu
authors.identifier: 0000-0002-7555-1654
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi Yokosuka City, Kanagawa 238-8567, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okada
authors.affiliation: Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi Yokosuka City, Kanagawa 238-8567, Japan.
authors.forename: Risa
authors.initials: R
authors.lastname: Matsumoto
authors.affiliation: Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi Yokosuka City, Kanagawa 238-8567, Japan.
authors.forename: Kazuhiro
authors.identifier: 0000-0003-1419-972X
authors.initials: K
authors.lastname: Nishida
authors.affiliation: Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi Yokosuka City, Kanagawa 238-8567, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Komuro
authors.affiliation: Department of Pathology, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi, Yokosuka, Kanagawa 238-8567, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Iida
authors.affiliation: Department of Pathology, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi, Yokosuka, Kanagawa 238-8567, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Tsujimoto
authors.affiliation: Department of Surgery, Yokosuka General Hospital Uwamachi, 2-36 Uwamachi Yokosuka City, Kanagawa 238-8567, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Suganuma