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Perforated diverticulum of the terminal ilenum

A previously unreported cause of suppurative pylephlebitis and multiple hepatic abscesses

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Summary

We describe the case of a 58-year-old man who presented to the hospital with central abdominal pain, nausea, fever, chills, and dyspnea. While in the hospital, jaundice appeared and the liver function tests revealed features of both cholestasis and hepatocellular injury. He developed gram-negative septicemia and died on the sixth hospital day. Autopsy disclosed a perforated terminal ileal diverticulum and a contiguous mesenteric abscess. These was also severe phlebitis of mesenteric venous radicles which extended superiorly to the intrahepatic portal venules and veins. The portal veins were surrounded by multiple hepatic abscesses that varied in size from microscopic to 2.5 cm. This appears to be the first report in the world literature of suppurative pylephlebitis and hepatic abscesses resulting from a perforated ileal diverticulum. The subject of small bowel non-meckelian diverticulosis is reviewed because of the rarity of this condition and the diagnostic challenges it poses.

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Authors and Affiliations

  1. Department of Pathology, Harlem Hospital Center, College of Physicians and Surgeons KP8115, Columbia University, 506 Lenox Avenue, 10037, New York, New York

    Carlos Navarro MD, David J. Clain MD & Preetham Kondlapoodi MD

  2. Division of Gastroenterology, Department of Medicine, Harlem Hospital Center, College of Physicians and Surgeons, KP 8115, Columbia University, New York, New York

    Carlos Navarro MD, David J. Clain MD & Preetham Kondlapoodi MD

Authors
  1. Carlos Navarro MD
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  2. David J. Clain MD
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  3. Preetham Kondlapoodi MD
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Navarro, C., Clain, D.J. & Kondlapoodi, P. Perforated diverticulum of the terminal ilenum. Digest Dis Sci 29, 171–177 (1984). https://doi.org/10.1007/BF01317061

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  • DOI: https://doi.org/10.1007/BF01317061

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