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J Korean Soc Emerg Med > Volume 14(5); 2003 > Article
Journal of The Korean Society of Emergency Medicine 2003;14(5): 697-700.
Perforation of The Small Bowel Diverticulum with Primary Non-Hodgkin's Lymphoma of the Terminal Ileum
Hyuk Joong Choi, Bo Seung Kang, Tai Ho Im
Department of Emergency Medicine, Hanyang University, College of Medicine, Seoul, Korea. erthim@hanyang.ac.kr
With the exception of Meckel's diverticulum, a small bowel diverticulum is an acquired disease due to high pressure in the small bowel lumen. The causes of the increase in the pressure of the lumen are usually a motility disorder of the small bowel, a luminal obstruction due to a tumor mass, or adhesion of the bowel loop. The prevalence of small bowel diverticulum increases with age, but the clinical manifestations are asymptomatic or nonspecific, such as vague abdominal pain, nausea, vomiting, indigestion, constipation, and diarrhea. Therefore, the disease is relatively difficult to diagnose until complications, such as perforation, obstruction, intussusception, or hemorrhage, develop. Because of its rarity, Physicians usually neglect to rule out small bowel diverticulitis. As the proportion of the elderly increases, the rate of small bowel diverticulitis will increase. If complications from small bowel diverticulitis develop in the elderly, mortality and morbidity may increase. To detect small bowel diverticulitis before complications develop, emergency physicians need to be aware of small bowel diverticulitis in elderly patients with abdominal pain of uncertain cause and need to evaluate it with multiple diagnostic tools. We report a case of perforation of a small bowel diverticulum due to intestinal obstruction caused by primary Non-Hodgkin's lymphoma of the terminal ileum.
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