Perforated Jejunal Diverticulitis

Abstract

Small intestinal diverticula are very rare; their incidence ranges from 0.06 to 1.3%, with a higher prevalence after the 6th decade of life. Among these small intestinal diverticula, duodenal diverticula are more frequent, followed by diverticula of the jejunum and ileum. A jejunal diverticulum is usually asymptomatic; sometimes patients complain of vague chronic symptoms like malabsorption, pain, or nausea that easily lead to misdiagnosis. Complications are rarely reported, only in 10% of patients. We report a unique case of a 70-year-old female who presented with confusion due to sepsis from perforated jejunal diverticulitis, which was successfully managed with initial resuscitation and definitive surgery.

Acute Abdomen – Rare Cause, Accurate Diagnosis, Simple Solution

“…It is an acquired herniation of the mucosa and submucosa through a weakened area of the muscularis layer of the small bowel wall [2-4, 6-8, 10]. The probability of finding diverticula decreases towards the ileocecal valve and these are much less common than colonic diverticula because of larger size, better intra-luminal flow and relatively sterile jejunal content [2,6,9,13]. The higher prevalence in the jejunum is also due to larger vasa recta and anastomotic arcades arising from the superior mesenteric artery [3,4,6].…”

“…The true aetiology is likely multifactorial and it is thought to be a result of intestinal dyskinesia and disorders of the myenteric plexus, producing high pressure localized areas in the bowel wall [2-6, 8, 12]. These diverticula are associated with disorders such as progressive systemic sclerosis, visceral neuropathies, and myopathy [2,14].…”

“…Sommering was the first to report acquired jejuno-ileal diverticula in 1794 and later the disease was described by Cooper in 1807 [1,2]. Jejunal diverticula occur in less than 1% of the population [1][2][3][4][5][6][7][8][9][10][11][12].…”

“…Sommering was the first to report acquired jejuno-ileal diverticula in 1794 and later the disease was described by Cooper in 1807 [1,2]. Jejunal diverticula occur in less than 1% of the population [1][2][3][4][5][6][7][8][9][10][11][12]. The prevalence is higher in patients between 60 and 70 years and slightly more common in men [1,2,[6][7][8][9][10][11]13].…”

“…Jejunal diverticula occur in less than 1% of the population [1][2][3][4][5][6][7][8][9][10][11][12]. The prevalence is higher in patients between 60 and 70 years and slightly more common in men [1,2,[6][7][8][9][10][11]13]. They are false diverticula located predominantly on the mesenteric side of the bowel [1,[4][5][6][7][8]13].…”