Laparoscopic Diagnosis and Management of an Acute Jejunal Diverticulitis

Abstract

Jejunal diverticulitis is a rare clinical entity with a high degree of clinical variability and nonspecific radiographic findings, making it a diagnostic challenge. Definitive diagnosis is typically not made until surgery is undertaken, most commonly by laparotomy. We present a case of laparoscopic diagnosis and management of an elderly man with an acute jejunal diverticulitis. The use of a laparoscopic approach provided for an effective therapy without any perioperative morbidity. Clear visualization of the extent of the disease allowed us to avoid intestinal resections. Laparoscopic washout and postoperative bowel rest and intravenous antibiotics seem to be sufficient for acute nonperforated jejunal diverticulitis. Despite his advanced age, our management allowed for a speedy and uneventful recovery in our patient. As a result, we advocate that diagnostic laparoscopy should be considered in most cases of suspected acute jejunal diverticulitis. In addition to facilitating a correct diagnosis, laparoscopic exploration and washout may provide effective management of the acute attack while obviating the need for major abdominal explorations and resections.