Perforated Jejunal Diverticulitis Managed Laparoscopically: A Case Report

腹腔镜治疗穿孔性空肠憩室炎:病例报告

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Abstract

Jejunal diverticulosis is an uncommon condition that is frequently asymptomatic but may present with serious complications such as diverticulitis and, more rarely, perforation. Its clinical presentation is typically nonspecific and often mimics more common abdominal emergencies, which can delay diagnosis and treatment. We report the case of a 63-year-old woman who presented with diffuse abdominal pain, vomiting, and absence of flatus. Computed tomography revealed jejunal wall thickening, multiple diverticula, mesenteric fat stranding, and localized pneumoperitoneum. Diagnostic laparoscopy identified a perforated jejunal diverticulum approximately 20 cm distal to the ligament of Treitz. A 20-cm jejunal segment containing multiple inflamed diverticula was resected, and a primary stapled side-to-side anastomosis was performed. The postoperative course was uneventful, and the patient was discharged on postoperative day four. Histopathology confirmed jejunal diverticulosis with associated inflammation. This case highlights the diagnostic challenges of jejunal diverticulitis and supports the role of individualized, context-specific surgical decision-making. Minimally invasive resection may be a safe and effective approach in select patients with localized perforation.

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