Perforated jejunal diverticulitis in a nonagenarian veteran: A case report

Jejunal diverticulitis: A new case report and a review of the literature

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Jejunal diverticulitis is a rare condition.

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The computed tomography is now the best diagnostic imaging method.

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There is no consensus on therapeutic strategy and management of jejunal diverticulitis

Small bowel diverticula in elderly patients: a case report and review article

Background

Small intestine diverticula are rare findings that were mostly reported in the elderly population as asymptomatic findings. However, they can also present with a wide range of symptoms (bloating, early satiety, chronic abdominal discomfort, and diarrhea/steatorrhea) or complications (gastrointestinal bleeding, small bowel obstruction, acute diverticulitis, or perforation) which in turn warrant medical treatment or urgent surgical intervention.

Case presentation

This is a case report of an 84-year-old female who presented with an acute surgical abdomen. An exploratory laparotomy revealed complicated small bowel diverticula with a jejunal diverticulum perforation, for which a diverticulectomy was performed.

Conclusions

Throughout this paper, we are aiming to outweigh the consideration of the possibility of complicated small bowel diverticula as a differential in the evaluation of any acute abdomen, especially in the elderly, which warrants emergency surgical management.

Perforated Jejunal Diverticulitis: a rare cause of acute abdominal pain

It is imperative for surgeons to have a heightened awareness of complications of jejunal diverticular disease so that they can act quickly and contribute to a successful clinical outcome for their patients.

Perforated jejunal diverticulitis: a rare but important differential in the acute abdomen

BACKGROUND

Diverticulosis of the small bowel is rare and, in most cases, discovered incidentally. However, diverticulitis and other complications are important to consider in the differential of an acute abdomen, especially in the elderly population.

CASE PRESENTATION

The patient was a 59-year-old female who presented with acute lower abdominal pain progressing to peritonitis. Computed tomography scan showed a large inflamed and perforated diverticulum on the mesenteric side of the jejunum. Exploratory laparotomy revealed a dilated proximal jejunum with a 5-cm inflamed and perforated mesenteric diverticulum. A small bowel resection with primary anastomosis was performed.

CONCLUSIONS

Jejunal diverticulitis remains a diagnostic challenge. Although uncommon, owing to its high mortality rate, it is an important clinical entity to consider and requires timely management.

Perforación de yeyuno por enfermedad diverticular: una condición a considerar en ancianos

La enfermedad diverticular constituye la principal afección intestinal después de los 40 años; tiene gran relevancia por sus amplias manifestaciones, que llevan a consultas frecuentes en todos los servicios de urgencias y corresponden al hallazgo más usual en los procedimientos endoscópicos electivos. Por su parte, la diverticulosis del intestino delgado tiene una prevalencia que oscila entre 2 % y 5 %. Las presentaciones clínicas como sangrado, obstrucción, dolor abdominal, perforación, formación de abscesos y fístulas suelen ser más floridas cuando afectan el colon. Se presenta el caso de un paciente anciano quien consultó a urgencias con abdomen agudo secundario a peritonitis generalizada por perforación intestinal debida a enfermedad diverticular del yeyuno.