Table 1: Patients characteristics
Patient 1 | Patient 2 | Patient 3 | |
---|---|---|---|
Age/sex | 58/F | 70/M | 66/F |
66/F | 120/75 | 120/70 | 90/60 |
Heartbeats per minute | 85 | 90 | 77 |
Body temperature (℃) | 37 | 36.5 | 36.9 |
Oxygen saturation (%) | 97 | 98 | 96 |
Creatine kinase (U/L) | 35 | 50 | 38 |
Lactate (mmol/L) | 1.9 | 2.2 | 2.4 |
PH | 7.4 | 7.39 | 7.39 |
C-reative protein (mg/dL) | 4 | 27 | 15 |
Leukocyte count (number/L) | 15000 | 13000 | 14000 |
Clinical presentation | One month of abdominal pain at the upper quadrants, with fever and vomit. | Abdominal pain with fever and nausea from two weeks. | Abdominal pain at the lower quadrants. No fever and vomit. |
Diagnostic suspicion after RX and US | Pyelonephritis | Non-specific suspect | Non-specific suspect |
Antibiotic therapy plans to the hospitalization | Clarithromycin 500 mg 2 times/day, Metronidazole 500 mg 3 times/day. | Piperacillin-Tazobactam 4.5 gr. every 8 hours, Metronidazole 500 mg 3 times/day. | Clarithromycin 500 mg 2 times/day, Metronidazole 500 mg 3 times/day. |
CT findings | No free air, single jejunal diverticula with parietal thickening and lymph nodes reactivity. | Thickening of an jeunal loop in the context of numerous diverticula of small bowel. Dishomonegenity of perivisceral fat and lymph nodes reactivity with area of perforation stopped up with sigmoid epiploic appendix and presence of purulent material. | Diverticulum of small bowel with inflammation of perifocal fat and moderate fluid collection in the pelvic incavum. Other diverticula in the proximal ileus. |
Surgical treatment | Lysis of adhesions and jejunal resection with primary anastomosis. | Jejunal resection with primary anastomosis. Appendicectomy. Cultural exam of the siero-ematic fluid. | Lysis of adhesions and ileal resection with primary anastomosis. Cultural exam of the siero-ematic fluid. |
Histological | Acute necrotizing inflammation of the diverticular perimeter. | Chronic granulomatous inflammation with perforation and abscess. | Inflammation, abscesses and acute perforated diverticulitis. |
Outcome | No complications, discharged on day 6. | No complications, discharged on day 7. | No complications, discharged on day 7. |
Abbreviations: mmHg = Millimeters of Mercury; ℃ = Celsius Degrees; U/L = Unit/Liter; mmol/L = Millimoles/Liter; mg/Dl = Milligrams/Deciliter.