{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T08:26:14Z","timestamp":1775895974580,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2008,3,12]],"date-time":"2008-03-12T00:00:00Z","timestamp":1205280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Jejunal diverticula are rare lesions, and when complications arise, they pose diagnostic difficulties. Perforation is a common complication resulting in an acute abdomen, although preoperative diagnosis is usually not possible. The \u201cgold standard\u201d for management for patients with complications is surgery. We present a series of patients with perforated jejunal diverticula who were on prolonged treatment with nonsteroidal anti\u2010inflammatory drugs <jats:bold>(<\/jats:bold>NSAIDs) and steroids for Chikungunya fever.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>There were a total of six patients, all of them presenting with perforative peritonitis, with or without shock. Plain abdominal radiogram and ultrasonogram confirmed this, although the exact site of the perforation was not diagnosed preoperatively. All patients underwent exploratory laparotomy and perforated jejunal diverticulum was found. Resection and anastomosis was performed in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean operating time was 113.5\u00a0minutes, and the blood loss was not significant. Postoperative course was uneventful except wound infection in two patients. There was no mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prolonged NSAID and steroid use are known to cause ulceration\/perforation of the upper digestive tract and colonic diverticula. This seems to be the most likely cause for the perforation of jejunal diverticula in our series of patients. This view is supported by the absence of inflammation and infiltration of neutrophils on histopathological examination of the diverticula.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-008-9469-0","type":"journal-article","created":{"date-parts":[[2008,3,11]],"date-time":"2008-03-11T01:18:27Z","timestamp":1205198307000},"page":"1420-1424","source":"Crossref","is-referenced-by-count":18,"title":["Perforation of Jejunal Diverticula in Steroids and Nonsteroidal Anti\u2010Inflammatory Drug Abusers: A Case Series"],"prefix":"10.1002","volume":"32","author":[{"given":"Chinnusamy","family":"Palanivelu","sequence":"first","affiliation":[{"name":"GEM Hospital &amp; Postgraduate Institute 45\u2013A, Pankaja Mill Road 641045 Ramnathapuram Coimbatore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muthukumaran","family":"Rangarajan","sequence":"additional","affiliation":[{"name":"GEM Hospital &amp; Postgraduate Institute 45\u2013A, Pankaja Mill Road 641045 Ramnathapuram Coimbatore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subbiah","family":"Rajapandian","sequence":"additional","affiliation":[{"name":"GEM Hospital &amp; Postgraduate Institute 45\u2013A, Pankaja Mill Road 641045 Ramnathapuram Coimbatore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gobi Shanmugam","family":"Maheshkumaar","sequence":"additional","affiliation":[{"name":"GEM Hospital &amp; Postgraduate Institute 45\u2013A, Pankaja Mill Road 641045 Ramnathapuram Coimbatore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhupalayam Velusamy","family":"Madankumar","sequence":"additional","affiliation":[{"name":"GEM Hospital &amp; Postgraduate Institute 45\u2013A, Pankaja Mill Road 641045 Ramnathapuram Coimbatore India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,3,12]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"383","article-title":"Small\u2010bowel diverticulosis: perceptions and reality","volume":"184","author":"Akhrass R","year":"1997","journal-title":"J Am Coll Surg"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000051978"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198811000-00013"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572\u20100241.1998.00357.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00311506"},{"key":"e_1_2_6_7_2","first-page":"26","article-title":"Perforated jejunal diverticula","volume":"62","author":"Koger KE","year":"1996","journal-title":"Am Surg"},{"issue":"1183","key":"e_1_2_6_8_2","first-page":"631","article-title":"Delayed diagnosis of steroid\u2010induced colon diverticulum perforation","volume":"116","author":"Kouyialis A","year":"2003","journal-title":"NZMJ"},{"key":"e_1_2_6_9_2","first-page":"423","article-title":"Occurrence of peritonitis during ACTH administration","volume":"62","author":"Beck JC","year":"1950","journal-title":"Can Med Assoc J"},{"key":"e_1_2_6_10_2","first-page":"93","article-title":"Non\u2010steroidal anti\u2010inflammatory drugs and perforated diverticular disease: a case\u2010control study","volume":"84","author":"Goh H","year":"2002","journal-title":"Ann R Coll Surg Engl"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002619900433"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0248\u20108663(96)80678\u20103"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90667-2"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042737\u2010199904000\u201000004"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20101999\u201075"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.3.348"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4221"},{"key":"e_1_2_6_18_2","first-page":"137","article-title":"Detection and prevention of NSAID\u2010induced enteropathy","volume":"3","author":"Davies NM","year":"2000","journal-title":"J Pharm Pharmaceut Sci"},{"key":"e_1_2_6_19_2","first-page":"521","article-title":"Perforated jejunal diverticulum: a rare cause of acute abdomen","volume":"57","author":"Costa G","year":"2005","journal-title":"Chir Ital"},{"key":"e_1_2_6_20_2","first-page":"1929","article-title":"Nonsurgical management of acute jejunal diverticulitis: a review","volume":"92","author":"Novak JS","year":"1997","journal-title":"Am J Gastroenterol"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-008-9469-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-008-9469-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-008-9469-0","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T15:09:22Z","timestamp":1703603362000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-008-9469-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,3,12]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2008,7]]}},"alternative-id":["10.1007\/s00268-008-9469-0"],"URL":"https:\/\/doi.org\/10.1007\/s00268-008-9469-0","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,3,12]]}}}