Jejunal diverticulitis: things to know to prevent diagnostic mistake

The jejunal diverticula are relatively rare. A female patient was admitted at our emergency department with acute abdominal pain and vomiting. CT-scan of the abdomen showed multiple diverticula in the colon and multiple intra-abdominal fluid collections, also in the left quadrants of the abdomen. Free intraperitoneal extraluminal air was also observed, suggesting bowel perforation. Surgical exploration showed multiple diverticula of the jejunum with a perforated jejunal diverticulum extending approximately 10 cm from ligament of Treitz. Jejunal resection was performed. Jejunal diverticulitis is rare, but it can lead to an acute abdomen increasing mortality especially in elderly patients. Jejunal diverticulitis usually starts with features that mimic colonic diverticulitis. In patients with personal history of colonic diverticulosis and suspected diverticulitis, jejunal or ileal diverticulitis must be excluded occurring with a frequency of 2.3% in patients with known diverticulosis. In absence of pathognomonic colonic diverticulitis CT findings, small intestine acute complicated diverticulitis should be always suspected. In complicated jejunal diverticulitis surgical treatment is mandatory and a laparotomy can be needed for a better management. (www.actabiomedica.it)