International Surgery Journal | November 2023 | Vol 10 | Issue 11 Page 1
International Surgery Journal
Verma S et al. Int Surg J. 2023 Nov;10(11):xxx-xxx
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Case Report
Perforated jejunal diverticulitis a rare cause of acute abdomen type of
article: case report
Sandeep Verma
1
*, Vidit
1
, Arnav Gupta
1
, Bhavinder K. Arora
1
, Rituparna Chatterjee
2
INTRODUCTION
Jejunal diverticulosis are rare congenital or acquired
anomalies of gastrointestinal tract; are false diverticula
which is characterized by herniation of mucosa and
submucosa through muscular layer of bowel, with a
reported incidence of approximately less than 1% in the
general population.
1,2
Although they are asymptomatic,
can lead to complications such as diverticulitis,
hemorrhage, or perforation which necessitates medical
attention and prompt surgery intervention. Acquired
jejunal diverticular perforation is a rare presentation that
possesses diagnostic challenges due to its nonspecific
presentation.
3,4
We present this case of a 75-year lady
presented to the emergency department with complaints
of generalized pain in the abdomen with multiple
episodes of vomiting, guarding and rebound tenderness.
This case report outlines the clinical presentation,
diagnostic work up, surgical intervention and post
operative course of our patient, drawing upon recent
articles and literature to provide context for this
challenging clinical scenario.
CASE REPORT
A 75-year elderly lady who came to the emergency
department with the complaints of generalized pain in the
abdomen for one day, which was sudden in onset and
gradually progressive associated with multiple episodes
of bilious vomiting and constipation. She had no history
of chronic illness or any previous surgery. On
examination, she was dehydrated, malnourished, her
ABSTRACT
Jejunal diverticulosis are false diverticula which is characterized by herniation of mucosa and submucosa through
muscular layer of bowel; their perforation is rare but potentially a life-threatening condition that can present as
peritonitis. In this case report, a 75-year lady presented to the emergency department with complaints of generalized
pain in the abdomen with multiple episodes of vomiting and signs of peritonitis. Radiological evaluation, X-ray of
abdomen suggestive of pneumoperitoneum, raising suspicion of a bowel perforation. The patient was immediately
resuscitated and promptly managed by surgical intervention. Intraoperatively, multiple jejunal diverticular
perforations identified and managed by resection and anastomosis of affected jejunal segment. This case report
outscores presentation, early diagnosis and surgical intervention in such rare and challenging cases for better
outcomes. The purpose of this case report is to highlight the clinical presentation, diagnostic work up, surgical
intervention and postoperative outcomes in jejunal diverticular perforation as a differential diagnosis in elderly patient
with acute abdominal pain and to discuss the current management strategies based on the latest research findings.
Keywords: Pneumoperitoneum, Jejunal diverticula, Resection and anastomosis, Perforation peritonitis, False
diverticula
1
Department of General Surgery, PGIMS, Rohtak, Haryana, India
2
Department of Emergency Medicine, SPS Hospital, Ludhiana, Punjab, India
Received: 03 September 2023
Revised: 03 October 2023
Accepted: 06 October 2023
*Correspondence:
Dr. Sandeep Verma,
E-mail: Drsaneepverma2201@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-2902.isj2023xxxx