abdominal pain, diverticulitis, diverticulum, small bowel resection
Diagnosis | Digestive System Diseases | Gastroenterology | Surgery
Introduction: Jejunal diverticulosis is a rare condition with clinical incidence of 0.5%. It is less common than colonic and duodenum diverticulosis. It is usually asymptomatic and diagnosed incidentally but it may cause chronic symptoms and acute complications. The aim of the case report to increase the awareness about the disease Case Report: This is a 56-year-old Caucasian male who presented with abdominal pain and fever and was diagnosed with transverse colon diverticulitis with microperforation on CT scan. Patient was treated nonoperatively with antibiotics and was discharged home. Two months later, he presented with similar recurrent abdominal pain and was found to have leukocytosis and jejunal small bowel inflammation with microperforation and abscess formation. MRI Enterography was obtained and showed small bowel diverticulitis. Patient was taken to OR and underwent small bowel resection and primary anastomosis. Patient did well and was discharged home. Discussion: Jejunal diverticulosis etiology is unknown but believed to be result of intestinal dyskinesia. It is more common in older patient and majority of cases are asymptomatic. It is associated with complications as stasis, bacterial overgrowth, malabsorption, bleeding, diverticulitis and perforation. Treatment of choice for perforated jejunal diverticulitis is segmental resection, if diverticula is extensive, resection is limited to include only the perforated diverticulitis and leave the nonperforated diverticula to avoid short bowel syndrome. In our case, jejunal diverticulosis segment was 50 cm, so decision was made to resect the whole segment including the perforated diverticulitis. Conclusion: Jejunal diverticulitis is uncommon and can be misdiagnosed. Awareness of the disease and have it in the differential diagnosis of abdominal pain will lead to right diagnosis. CT and MRI are helpful tool in making the diagnosis and evaluating its extent
Publisher or Conference
Southeastern Surgical Congress Annual Scientific Meeting
Nagi M, Deturris S, Ang D. A rare case of perforated jejunal diverticulitis. Poster presented at: Southeastern Surgical Congress; February 8-11, 2020; New Orleans, LA.