Perforated Jejunal Diverticulum Mimicking Diverticulitis: A Case Report of Acute Abdominal Pain in an Elderly Patient.

Jejunal diverticulosis is a rare form of diverticulosis characterized by acquired pseudodiverticula in the small bowel. Although most cases are asymptomatic, the condition can present diagnostic challenges due to its atypical presentation. Complications such as perforation can lead to acute abdomen, significantly increasing morbidity and mortality. We report a rare case of perforated jejunal diverticulitis in an 84-year-old female with a known history of diverticular disease. The patient presented to the emergency department with worsening left lower quadrant abdominal pain. A computed tomography (CT) scan revealed a focus of air adjacent to the mesentery, indicative of bowel perforation. An urgent exploratory laparotomy was performed, which identified a 4-cm perforated jejunal diverticulum. The affected segment of the small bowel was resected, followed by primary side-to-side jejunal anastomosis. The patient was discharged home in stable condition following uneventful postoperative recovery. This case highlights the importance of including jejunal diverticulosis in the differential diagnosis of acute abdomen, particularly in elderly patients with a history of diverticular disease. Due to the nonspecific presentation, prompt imaging is crucial for diagnosis. Surgical intervention is often necessary in cases of perforation. Increased clinical awareness of this rare condition may help reduce diagnostic delays and improve patient outcomes.