於非類固醇抗發炎藥物使用者所見之穿孔性空腸憩室症：個案報告與文獻回顧

Perforated Jejunal Diverticulum in A Nonsteroidal Anti-Inflammatory Drug User: A Case Report and Review of the Literature

空腸憩室穿孔是一個少見且難以診斷的疾病，在此我們提出一空腸憩室穿孔併腹膜炎的病例報告。一位82歲長期服用非類固醇抗發炎藥物的女性，因左側腹痛一天無法緩解至本院急診求診，腹部電腦斷層顯示空腸憩室穿孔與些許游離氣體，病人接受內科支持性療法，爾後獲得改善而痊癒出院。在臨床上，年長且使用類固醇或非類固醇抗發炎藥物的病人，有較高穿孔的風險。雖然手術治療適用於穿孔情形，但在穩定的病例中，使用保守性內科療法並小心觀察其病程，需要時再施行外科手術，亦是可行的治療方法。

Jejunal diverticulum perforation is uncommon and difficult to diagnose. We report a case of jejunal diverticulum complicated with perforation and peritonitis. An 82-year-old lady with long-term use of NSAID presented with a one-day history of left-side abdominal pain. Abdominal computed tomography (CT) scan revealed free air induced by perforated jejunal diverticula. However, the patient recovered with the conservative treatments. Clinically, elderly jejunal diverticula patients on NSAID or steroids use might have higher risks of perforation. Surgery is usually indicated in patients with perforation, but conservative treatment could be also considered first in the stable cases.