A case of jejunal perforation secondary to jejunal diverticulosis in a patient with COVID-19 pneumonia
Keywords:Jejunal diverticulosis, Jejunal perforation, COVID-19 pneumonia, Gastrointestinal symptoms in COVID-19 disease
Jejunal diverticulitis is a rare disease, with jejunal perforation as its rarest complications due to low intraluminal pressure. Since the current pandemic of COVID-19 it has shown to be affecting gastrointestinal system in a proportion of patients, and worsening of pre-existing GI conditions. We encountered a case of a 75 years old gentleman, suffering with severe COVID-19 pneumonia, who during the course of the disease presented with spontaneous Jejunal perforation, secondary to jejunal diverticulosis. Jejunal diverticula are the least common type of small bowel diverticula & perforation as their complication is the rarest of all complications. Their presentation is variable from asymptomatic to chronic abdominal symptoms and the complications such as perforation as described in our case. Their relative clinical rarity and varied presentation may make diagnosis both delayed and difficult.
Chiu EJ, Shyr YM, Su CH, Wu CW, Lui WY. Diverticular disease of the small bowel. Hepatogastroenterology. 2000;47(31):181-4.
Tsiotos GG, Farnell MB, Ilstrup DM. Nonmeckelian jejunal or ileal diverticulosis: an analysis of 112 cases. Surgery. 1994;116(4):726-31.
Baskin RH Jr, Mayo CW. Jejunal diverticulosis; a clinical study of 87 cases. Surg Clin North Am. 1952:1185-96.
Koger KE, Shatney CH, Dirbas FM, McClenathan JH. Perforated jejunal diverticula. Am Surg. 1996;62(1):26-9.
Herrington JL Jr. Perforation of acuired diverticula of the jejunum and ileum. Analysis of reported cases. Surgery. 1962;51:426-33.
Kotfis K, Skonieczna-Żydecka K. COVID-19: gastrointestinal symptoms and potential sources of SARS-CoV-2 transmission. Anaesthesiol Intens Ther. 2020;52(2):171-2.
Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for Gastrointestinal Infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-3.
Kerber GW, Greenberg M, Rubin JM. Computed tomography evaluation of local and extraintestinal complications of Crohn's disease. Gastrointest Radiol. 1984;9(2):143-8.