# Case report: Jejunal diverticulosis with chronic interstitial and mesenteric adhesions, chronic mesenteric volvulus, and decompensated small-bowel obstruction

## TL;DR

This case report describes a rare instance of jejunal diverticulosis complicated by adhesions and bowel obstruction, highlighting the importance of considering this condition in abdominal emergencies.

## Contribution

The paper presents a rare clinical case of jejunal diverticulosis with multiple complications, emphasizing its diagnostic challenges and management.

## Key findings

- Jejunal diverticulosis was diagnosed via laparoscopy in an 84-year-old man with acute abdominal pain.
- Resection of the affected jejunum led to excellent postoperative recovery.
- Histopathology confirmed diverticulosis with chronic fibrosis and strictures.

## Abstract

Jejunal diverticulosis has not gained significant attention because of its rarity and typically asymptomatic course as well as the relative diagnostic inaccessibility of the jejunum. This report presents a rare case of jejunal diverticulosis complicated with chronic interstitial and mesenteric adhesions, chronic mesenteric volvulus, and decompensated small-bowel obstruction.

An 84-year-old man was admitted to the emergency room with a 24-h history of acute colicky abdominal pain. He denied other signs or symptoms. The preoperative diagnosis based on physical and radiologic evaluations was challenging, and only diagnostic laparoscopy revealed extensive small-bowel diverticulosis. Midline laparotomy was performed as definitive surgery, revealing diverticulosis in the proximal 2-m section of the jejunum, starting approximately 20 cm from Treitz's ligament; the affected section was resected. The postoperative recovery was excellent. The histopathologic report confirmed substantial jejunal diverticulosis with chronic fibrosis, adhesions, and strictures.

Histopathologic evaluation is necessary because tumors can be misdiagnosed as diverticula. This case report should serve as a reminder for surgeons to be cognizant of the signs of uncommon conditions, such as jejunal diverticulosis.

Albeit rare, jejunal diverticulosis should be considered in the differential diagnosis of acute abdomen.

•Jejunal diverticulosis has not gained significant attention.•Diverticular disease is markedly less common in the small bowel than in the colon.•Laparoscopy revealed multiple diverticula in the proximal small intestine.•The affected small bowel was resected to prevent complications.•Histopathologic evaluation is necessary because tumors can be misdiagnosed as diverticula.

Jejunal diverticulosis has not gained significant attention.

Diverticular disease is markedly less common in the small bowel than in the colon.

Laparoscopy revealed multiple diverticula in the proximal small intestine.

The affected small bowel was resected to prevent complications.

Histopathologic evaluation is necessary because tumors can be misdiagnosed as diverticula.