Jejunal diverticular disease complicated with spontaneous perforation: A rare case of acute abdomen and literature review

Abstract

Introduction: The jejunal diverticular disease is an uncommon clinical pathology. In general, these diverticula are an incidentaloma found on imaging exams that can be seen in elective surgeries for other purposes. In a minority of cases it causes symptoms which result from serious complications such as perforation. Case report: A 56-year-old male patient, previously healthy and without comorbidities, was admitted to the emergency department due to abdominal pain which had started 24 hours ago, without improvement. On examination, the patient was in pain and in Mohammedan prayer's position in bed and had a distended abdomen with signs of peritoneal irritation. An abdominal tomography showed massive distension of intestinal loops and free fluid in the peritoneal cavity. He underwent exploratory laparotomy which showed multiple diverticula in the jejunum and one of them was perforated. Segmental enterectomy with primary anastomosis was performed. Conclusion: Complicated jejunal diverticular disease should be ranked among the differential diagnoses in acute perforating abdomen. Segmental jejunal resection is the treatment of choice. Keywords: small bowel diverticulum; jejuno-ileal diverticula; diverticulitis; perforation; acute abdomen; surgery.