[A rare cause of acute abdomen: jejunal diverticulitis].

INTRODUCTION

Jejunal diverticulitis is a rare cause of acute abdomen and is diagnosed preoperatively only infrequently.

CASE

A 34-year-old man presented with a history of increasing nonradiating epigastric and left upper abdominal pain and with fever, constipation, nausea and vomiting. His white blood cell count was 18,300/mm(3). Liver function tests and pancreatic enzymes were in the normal range. An abdominal CT scan showed jejunal diverticulitis and bubble gases in the extraluminal space. Perineal irritation led to an emergency midline laparotomy, which discovered diverticulitis of the jejunum at 50 cm from the Treitz ligament, resected the jejunum and performed end-to-end anastomosis. The pathology examination confirmed the diagnosis.

DISCUSSION

Because the clinical presentation of complicated jejunal diverticulitis is generally nonspecific, diagnosis is very difficult. CT scan is a reliable diagnostic tool. Surgery, including resection of the diseased bowel portion with direct anastomosis, is the treatment generally reported for small intestinal diverticulitis complicated by hemorrhage, obstruction, or perforation. Some authors report using medical treatment only for diverticulitis.