Elucidating jejunal diverticulosis: Diagnostic and treatment insights from a perforated case study

• Published in: International journal of surgery case reports 2024-06, Vol.119, p.109726, Article 109726
• Main Authors: Gómez-Carrillo, Daniel, Núñez-Rocha, Ricardo E., Perdomo, Carlos Felipe, Fajardo, Roosevelt
• Format: Article
• Language: English
• Subjects: Case report; Complication; Jejunal diverticulum; Perforation
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109726

Diverticula are sac-shaped formations resulting from the inward folding of the intestinal wall's lining. While they predominantly occur in the colon, they can manifest in other parts of the gastrointestinal tract, with jejunal diverticulum being the most prevalent. Symptoms are infrequent in most cases, and when they do occur, intestinal perforation is the most severe complication. In such instances, prompt surgical intervention is imperative, typically entailing the excision of the affected intestinal segment, followed by a end-to-end anastomosis. A 75-year-old female patient presented at the emergency department with sharp abdominal pain. Imaging revealed the presence of perforated jejunal diverticula. Diagnostic laparoscopy confirmed a perforated jejunal diverticulum along with generalized peritonitis and multiple diverticula in the same region. Consequently, we performed a segmental intestinal resection and anastomosis. Jejunal diverticulosis, a rare condition primarily affecting the elderly, is found in 0.5–2.3 % of imaging studies. Although its exact cause remains elusive, potential contributing factors include abnormal intestinal movements and elevated gut pressure. Symptoms are generally vague, such as abdominal discomfort. Diagnosis often occurs incidentally during imaging, leading to a high mortality rate when complications occurs. While computed tomography (CT) scans are useful for detecting intestinal wall protrusions, definitive diagnosis typically requires laparoscopy or laparotomy. Treatment varies based on symptoms and complications, with surgery often necessary for perforations or when medical treatment fails. Jejunal diverticulosis is often asymptomatic or displays non-specific symptoms. Timely diagnosis and prompt surgical intervention in case of perforation is crucial. •Jejunal diverticula, though rare, are significant sac-shaped formations in the gastrointestinal tract than can cause perforation as a severe complication.•Jejunal diverticulosis presents vague symptoms.•Imaging and laparoscopy are vital in early detection, guiding effective treatment strategies.•Timely surgery is key for perforations or failed medical interventions.•Early diagnosis and timely surgical intervention are pivotal for successful outcomes.