CASE REPORT   

Journal of Radiological Review 2020 May-June;7(3):208-15

DOI: 10.23736/S2723-9284.20.00019-2

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English, Italian

Perforated jejunal diverticulitis: a rare acute abdomen etiology

Matteo MORENA ✉, Paola BRIGNONE

Unit of Radiology, Mons. Giovanni Galliano Hospital, ASL Alessandria, Acqui Terme, Alessandria, Italy

Multiple diverticulosis of the jejunum represents a very rare entity. The disease is often asymptomatic and must be considered in cases of unexplained malabsorption, anemia, chronic abdominal pain and discomfort. Jejunal diverticula become clinically relevant when complications, such as diverticulitis, perforation, intestinal hemorrhage or obstruction occur. The rarity of this condition makes differential diagnosis difficult. We report two cases, occurred in the last three years, of jejunal diverticulitis with a picture of localized peritonitis caused by a perforation of jejunal diverticulum in multiple diverticulosis of jejunum, one of them also complicated by small bowel obstruction from migration of an enterolith out of a diverticulum. Plain abdominal radiographs and ultrasound examination were not sufficient to get a correct diagnosis. Computed tomography (CT) helped to localize the inflammatory process in the jejunum and to identify the inflamed diverticulum. The CT features of this complication of this uncommon disease are described.

KEY WORDS: Jejunal diseases; X-ray computed tomography; Small intestinal diverticulosis; Diverticulitis; Acute abdomen; Intestinal obstruction