Perforated jejunal diverticulum treated by exteriorization in an adult patient with alcoholic psychosis: A case report

Abstract

We herein describe a surgical case of perforated jejunal diverticulum in an adult patient with alcoholic psychosis and dementia. A 70-year-old Japanese male presented with vomiting and abdominal pain in a mental hospital. He had undergone a distal gastrectomy, the details of which are unclear. He entered the internal medicine ward of our hospital and was diagnosed with bowel obstruction and conservatively treated with a long tube. At the 4th hospital day, he suffered from severe abdominal pain with muscular defense. Computed tomography revealed a dilated small intestine and intra-abdominal free air and ascites. After laparotomy, a perforated jejunal diverticulum was identified at 30 cm along the anal side from the ligament of Treitz. Adhesiolysis and exteriorization of the perforated jejunal diverticulum using a tube were performed, as the status of the patient was too serious to tolerate resection of the small intestine including the perforated lesion. The patient eventually recovered and left the hospital on Day 37 after the operation. This report presents a rare surgical case of perforated jejunal diverticulum due to small bowel obstruction in an adult patient with alcoholic psychosis and dementia.