Ann Surg Treat Res.  2014 Oct;87(4):209-212. 10.4174/astr.2014.87.4.209.

Small bowel diverticulosis in patient with early gastric cancer

• Kim PS
• Jung EJ
• Bang HY

• KMID: 1882827
• DOI: http://doi.org/10.4174/astr.2014.87.4.209

Abstract

Jejunal and ileal diverticula are rare in adults. Duodenal diverticula are five times more prevalent than jejunoileal diverticula. Most patients are asymptomatic. However, chronic symptoms including intermittent abdominal pain, flatulence, diarrhea and constipation are seen in 10%-30% of patients. Gastric cancer is the second most common cancer in South Korea and here we report a case of early gastric cancer with multiple duodenal and jejunal diverticula. A 67-year-old woman was admitted to Konkuk University Medical Center with chronic diarrhea and weight loss of 19 kg over 2 months. Following gastroduodenoscopy, we identified adenocarcinoma of the lower body of the stomach. On abdominopelvic computed tomography, diverticula of duodenum and jejunum were found. Patient underwent distal gastrectomy and gastroduodenostomy with lymphadenectomy. She was discharged on the tenth postoperative day without complications.

Keyword

Small Intestinal diverticulosis; Stomach neoplasms; Malabsorption syndromes

MeSH Terms

Abdominal Pain
Academic Medical Centers
Adenocarcinoma
Adult
Aged
Constipation
Diarrhea
Diverticulum*
Duodenum
Female
Flatulence
Gastrectomy
Humans
Jejunum
Korea
Lymph Node Excision
Malabsorption Syndromes
Stomach
Stomach Neoplasms*
Weight Loss

Figure

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  Fig. 1 Diverticula in the second and third portions of the duodenum on gastroduodenoscopy.

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  Fig. 2 Abdominopelvic computed tomography findings. Arrows point to the diverticula in duodenum and jejunum. (A, B) Axial view, (C, D) coronal view.

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  Fig. 3 Intraoperative findings showing diverticula in duodenum and jejunum. (A) Previous ulcer scar (arrow). (B) Diverticula in the second portion of the duodenum (arrows). (C) Jejunal diverticula on the mesenteric border of the small bowel. (D) Jejunal diverticula become smaller as we move distally until the diverticula disappear (arrow: terminal end of diverticula).

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