Perforated Jejunal Diverticulitis: Surgical and Antibiotic Management

TL;DR

This paper discusses a rare case of perforated jejunal diverticulitis in an elderly patient who died despite surgery and antibiotics.

Contribution

The paper contributes a rare clinical case highlighting the challenges in diagnosing and managing jejunal diverticulitis.

Findings

Jejunal diverticulitis is rare and often difficult to diagnose due to vague symptoms.

The case resulted in death despite surgical and antibiotic interventions.

There is limited literature and treatment guidelines for jejunal diverticulitis.

Abstract

Small bowel diverticulitis occurs at a rate of 0.06% to 1.3%, mainly in individuals over 50, peaking between ages 60 and 70. Duodenal diverticula are the most common (79% of cases), followed by jejunal or ileal diverticula (18%), and diverticula in all segments combined (3%). This condition typically presents with sporadic abdominal pain and vague gastrointestinal symptoms, making diagnosis difficult. We report an 80-year-old male who presented to the emergency department with sudden, left-sided abdominal pain and nausea due to perforated jejunal diverticulitis. Despite undergoing side-to-side jejunojejunostomy and incidental appendectomy, the patient rapidly declined and expired 45 hours post-operation due to septic shock. This case highlights the scarcity of literature on jejunal diverticulitis and its treatment guidelines.

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