Guidry SP, Poole GV: The anatomy of appendicitis. Am Surg 1994, 60 (1) : 68–71.PubMed 15. Marbury WB: The retroperitoneal (retrocolic) appendix. Ann Surg 1938, 107 (5) : 819–28.PubMedCrossRef Competing interests The authors declare that they have no competing interests. Authors’ contributions HK, JD and RG participated in the care of the patient, including the operative part. HK, JD and RG envisioned the concept of the manuscript. HK wrote the first draft of the manuscript JD and RG critically reviewed

the manuscript. HK, JD and RG all read and approved the final manuscript.”
“Introduction Multiple diverticulosis of the jejunum constitutes an uncommon pathology of the small bowel. The disease GW-572016 concentration is often asymptomatic and must be taken into consideration in cases of unexplained malabsorption, anemia, selleckchem chronic abdominal pain and discomfort. Related complications such as diverticulitis, hemorrhage, obstruction and perforation present high mortality and morbidity

rates. We herein report a case of a 55 year-old man presented at the emergency department because of acute abdominal pain, vomiting and fever. Preoperative radiological examination followed by laparotomy revealed multiple and giant jejunal diverticula causing Selleckchem PCI-34051 intestinal obstruction. We also review the literature for this uncommon disease. Case Presentation A 55-year old man arrived at the emergency department complaining of 48-hour lasting intense abdominal pain and vomiting. The patient had a free medical history and was not receiving any drugs Montelukast Sodium at that time. He mentioned a two-year-lasting remittent abdominal pain, fullness and often abdominal distension. The

patient also mentioned a particular intolerance of pulse and vegetables. Physical examination revealed a distended abdomen with increased bowel peristalsis. Rectal examination was normal. Only his temperature was elevated (38.2°C) while other vital parameters were within normal limits. Abnormal laboratory findings included leukocytosis (13300/mm3), anemia (Hct:30%), hypokalemia (3.2 mmol/l) and hypoalbuminemia (2.80 mmol/l). C-reactive protein was also elevated (4.57 mg/dl). A plain abdominal X-ray showed multiple air-fluid levels and dilated intestinal loops suggesting intestinal obstruction but not signs of perforation (Figure 1). Abdominal ultrasonography revealed dilated and hyperactive intestinal loops but not free intraperitoneal fluid. Gallstones were also incidentally found. The abdominal computed tomography (CT) scan demonstrated multiple distended small bowel loops and jejunal diverticula. The patient had a nasogastric tube and received intravenously fluids, antibiotics (ciprofloxacin and metronidazole) and parenteral nutrition. Within next 72 hours, temperature and leukocytosis were decreased while the X-ray of the abdomen did not reveal gas-fluid levels.