A Case Report Involving Surgical Acute Abdomen Caused by a Perforated Jejunal Diverticulum

Dragoș Voicu^1,2, Alexandra Toma^1,3*, Georgiana Bianca Constantin³* and Constantin Popazu¹

Received: August 05, 2022;   Published: August 11, 2022

DOI: 10.26717/BJSTR.2022.45.007236

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Abstract

Jejunal diverticulum represents an extremely rare gastrointestinal pathology. The clinical diagnosis is very challenging because the usual presentation of the patient is non-specific. We report a case of acute abdomen generated by the perforation of a diverticulum of the small intestine, with purulent, fetid, peritoneal abscess, emergency surgically managed. The patient, an 82-year-old man, was hospitalized with severe abdominal pain and toxic-septic condition. Paraclinical and imaging investigations have not been edifying in terms of etiology. Exploratory laparotomy identified a centro abdominal abscess, caused by a perforated inflammatory jejunal diverticulum, as well as an apparently uncomplicated sigmoid diverticulosis. Segmental enterectomy (about 20 cm) was performed, with the removal of the diverticulum and the restoration of the digestive transit by latero-lateral anastomosis. The etiology, the pathophysiology, the preoperative diagnosis and the complications of this type of lesion are discussed. The reported case demonstrates that this trivial pathological entity can evolve with various complications, potentially fatal, especially in elderly patients.

Keywords: Jejunal Diverticulum; Perforation; General Surgery; Laparotomy; Emergency Surgery