Case report: Jejunal diverticulosis with chronic interstitial and mesenteric adhesions, chronic mesenteric volvulus, and decompensated small-bowel obstruction.

INTRODUCTION

Jejunal diverticulosis has not gained significant attention because of its rarity and typically asymptomatic course as well as the relative diagnostic inaccessibility of the jejunum. This report presents a rare case of jejunal diverticulosis complicated with chronic interstitial and mesenteric adhesions, chronic mesenteric volvulus, and decompensated small-bowel obstruction.

PRESENTATION OF CASE: An 84-year-old man was admitted to the emergency room with a 24-h history of acute colicky abdominal pain. He denied other signs or symptoms. The preoperative diagnosis based on physical and radiologic evaluations was challenging, and only diagnostic laparoscopy revealed extensive small-bowel diverticulosis. Midline laparotomy was performed as definitive surgery, revealing diverticulosis in the proximal 2-m section of the jejunum, starting approximately 20 cm from Treitz's ligament; the affected section was resected. The postoperative recovery was excellent. The histopathologic report confirmed substantial jejunal diverticulosis with chronic fibrosis, adhesions, and strictures.

DISCUSSION: Histopathologic evaluation is necessary because tumors can be misdiagnosed as diverticula. This case report should serve as a reminder for surgeons to be cognizant of the signs of uncommon conditions, such as jejunal diverticulosis.

CONCLUSION

Albeit rare, jejunal diverticulosis should be considered in the differential diagnosis of acute abdomen.