Perforation of Diverticulum of Jejunum: A Rare Gastrointestinal Presentation

Abstract

Small bowel diverticula are very rare. The incidence ranges from 0.06 to 1.3%, with high prevalence after 60 years of age. Of these small intestinal diverticula, the duodenal diverticulum is more common, followed by jejunal and ileal diverticula. Jejunal diverticula are rare and are usually asymptomatic acquired lesions. If symptomatic, chronic nonspecific symptoms like pain, nausea and malnutrition may occur and sometimes acute symptoms such as gastrointestinal bleeding, peritonitis and obstruction may occur. Chronic pain and malabsorption occur in 40% of cases, but perforation occurs only in 2.3–6.4% of all patients with diverticula [1]. This case report describes a emergency case of 87 years old man with a 2 days history of pain abdomen. Plain radiograph study of abdomen shows the presence of gas under both diaphragmatic domes, suggesting a hollow viscus perforation. Physical examination suggested of soft abdomen with generalised tenderness of whole abdomen, more marked in right upper and lower quadrants. Emergency laparotomy was done, which revealed mesenteric border of jejunum having multiple diverticula, one of which was perforated approximately 15 cm distal to duodena-jejunal junction.