Non-operatively managed case of contained jejunal diverticular perforation

Abstract

Jejunal diverticulosis is an underdiagnosed condition due to its relatively benign existence and uncharacteristic presentation. The complications can be very severe and, due to its often late diagnosis, patients may require urgent surgery. We present a woman who initially complained of non-specific abdominal symptoms but was diagnosed with a contained jejunal diverticular perforation relatively early. We managed her non-operatively with intravenous antibiotics from which she recovered well. She was discharged 2 days later and has remained completely well. Follow-up at 3 months showed no recurrence. Our case differs from most of the literature due to the early diagnosis and successful non-operative management of the patient. We conclude that, in cases of non-specific abdominal pain with diagnostic ambiguity, a diagnosis of small bowel diverticulosis should be considered. It should be managed non-operatively where possible.

Keywords: gastrointestinal surgery; general surgery; surgery.

Figure 1

A sagittal CT section of a large jejunal diverticulum.

Figure 2

An axial CT section of a jejunal diverticulum, diameter 44.8 mm.