Jejunal Diverticula with PerforationA Case Report

Abstract

Jejunal diverticula with perforation is very rare. Incidence of Jejunal diverticula on enteroclysis is 2.0–2.3% and on autopsy it is 0.06–4.6%. Incidence of perforation in Jejunal diverticula is 2.3-6.4%. Pathologically it is pulsion type of pseudo diverticula occuring along the mesenteric border of the intestine, where the blood vessels pierce the muscularis layer causing weak areas to develop. These out-pouchings contain mucosa and submucosa only hence perforates easily. 74 year old male patient presents with pain in abdomen since 1 day. Patient was toxic and per abdomen examination shows diffuse tenderness+, guarding+, rigidity+, abdomen distention +, Bowel sounds absent. Erect X-ray abdomen showed air under the diaphragm. Emergency Laparotomy performed and multiple Jejunal diverticula with a perforation in mesenteric border of Jejunum was noted. Segmental Resection and end to end anastamosis was done. Postoperative period was uneventful. Jejunal diverticula with perforation is very rare and mostly an incidental finding during Laparotomy. Segmental Resection and anastamosis is the treatment of choice.

Keywords

• emergency laparotomy
• jejunal diverticula
• pseudodiverticula
• perforation
• resection and anastomosis