An Acute Abdomen Caused by a Contained Perforation of a Jejunal Diverticulum

Abstract Introduction A diverticulosis of the small bowel is often an incidental finding on imaging modalities or during surgery performed for another indication. Uncomplicated jejuno-ileal diverticulitis may be managed with intravenous antibiotics and bowel rest, while complications usually require surgical management. Perforated diverticulitis of the small bowel is a relatively rare cause of an acute abdomen; however, it should be considered in the differential diagnosis. Case presentation and study design We report a case of a 77-year-old female patient who presented with diffuse abdominal pain and localised guarding with rebound tenderness in the left mesogastrium. Computed tomography (CT) showed a thickened jejunal loop with free extraluminal fluid and air in the mesentery. An exploratory laparotomy confirmed the contained perforation of the jejunum, which required resection of the affected segment. In addition, we provide a review of similar cases reported over the last decade, focused on the clinical presentation and management. We used the relevant publications available in the PubMed database. They were identified by using the phrases "jejunal diverticulitis", "perforated jejunal diverticulitis", and "jejunal diverticulosis with perforation". Conclusion Most cases of perforated jejuno-ileal diverticulitis require resection of the affected segment with construction of a primary anastomosis. Besides the rarity and a non-specific clinical manifestation, it must be considered in the differential diagnosis of the acute abdomen, especially in elderly patients.