Perforated Jejunal Diverticulitis: An Uncommon Cause of Abdominal Pain

Abstract

Diverticular disease of the jejunum is a rare entity. Most patients with small bowel diverticula are asymptomatic. Patients who develop symptoms generally report symptoms that reflect associated complications. The most common are non specific epigastric pain or flatulent dyspepsia, mainly postprandial. Complications including haemorrhage, intestinal obstruction, diverticulitis and perforation may be life threatening and warrants early surgical intervention. We report a case of a 68-year-old male admitted with jejunal diverticulosis complicated by sealed off perforation and phlegmon formation who has been admitted and treated for abdominal pain previously with different diagnosis in two occasions, once with a diagnosis of symptomatic cholelithiasis and second time with mild pancreatitis which could be the manifestation of jejunal diverticulitis. On admission CT abdomen confirmed the diagnosis of diverticulitis and he underwent laparoscopic assisted resection of involved segment of jejunum and jejuno-jejunal anastomosis. On one year follow-up patient was pain free and symptom free throughout the period. The purpose of presenting this case is to evaluate a presentation of diverticulitis which can delay the diagnosis and contribute to diagnostic dilemma.

Keywords

• abscess
• diverticulosis
• enterectomy
• jejunal phlegmon
• peritonitis