Jejunal diverticulosis causing intestinal obstruction in a middle-aged man: a rare case emphasizing coexistence and potential association with colorectal carcinoma.

INTRODUCTION: Jejunal diverticulosis is a rare condition that usually remains asymptomatic but can occasionally lead to serious complications such as obstruction, perforation, or bleeding. Its vague presentation often delays diagnosis. In exceptional cases, it may coexist with other intra-abdominal pathologies such as colorectal malignancy, complicating both diagnosis and management.

CASE PRESENTATION: A 45-year-old male presented with 5 days of abdominal distension, vomiting, and colicky pain. Imaging revealed small bowel obstruction due to multiple jejunal diverticula and an incidental cecal mass suspicious for malignancy. Exploratory laparotomy confirmed multiple large jejunal diverticula with an epiploic adhesion band causing proximal jejunal ischemia, along with a firm cecal growth consistent with the CT findings. Diverticulectomy with segmental jejunal resection and right hemicolectomy were performed. The patient declined postoperative oncologic consultation and further histopathological evaluation of the cecal mass. His postoperative recovery was uneventful, and he was discharged on the seventh day.

CLINICAL DISCUSSION: This case underscores the diagnostic complexity of jejunal diverticulosis presenting with intestinal obstruction, further complicated by a concurrent cecal mass. Surgical management was directed at resolving the obstruction and ensuring oncologic safety through resection. Such scenarios highlight the importance of individualized intraoperative judgment, especially when patient preferences limit further investigation and treatment.

CONCLUSION: Jejunal diverticulosis should be considered in unexplained small bowel obstruction. When an incidental mass is encountered intraoperatively, simultaneous resection is justified, particularly if oncologic follow-up is uncertain. Early surgical intervention remains key to preventing ischemic complications and achieving favorable outcomes.