Rare Jejunal Diverticulitis: Case Report of Abscess and Perforation

Rare Jejunal Diverticulitis Leads to Abscess and Perforation

A rare case of jejunal diverticulitis complicated by abscess formation and perforation has highlighted the importance of considering this condition in the differential diagnosis of patients presenting with abdominal pain.

This case involved a 48-year-old male who arrived at the emergency department complaining of severe abdominal pain that had been worsening for the past three days. The pain was primarily centered in the epigastric region and radiated to the back. He also reported nausea, vomiting, and fever.

“He described the pain as sharp and stabbing in nature, exacerbated by movement and deep breaths,” physicians noted in the medical report.

His medical history was significant for hypertension, hyperlipidemia, and a history of smoking. Physical exam revealed tenderness in the epigastric region with guarding.

Initial laboratory tests showed elevated white blood cell count, indicating inflammation, and C-reactive protein, a marker of infection. A computed tomography (CT) scan of the abdomen and pelvis revealed a dilated loop of jejunum with circumferential wall thickening, suggestive of inflammation.

“Furthermore, there was a 3xCm fluid collection adjacent to the jejunal loop, which raised concern for an abscess,” the medical team documented.

The patient was started on intravenous antibiotics and underwent drainage of the abscess under computed tomography guidance. Following this procedure, his symptoms began to improve.

Further investigation revealed the presence of multiple jejunal diverticula, small pouches that bulge outward from the intestinal wall.

“The combination of jejunal diverticula, inflammation, and abscess formation, ultimately leading to perforation, is a rare occurrence,” the physicians explained.

Divided into segments by the ligament of Treitz, the small intestine is comprised of the duodenum, jejunum, and ileum.

“Jejunal diverticula, though relatively uncommon, are a recognized cause of gastrointestinal bleeding, abdominal pain, and perforation,” the report stated.

They emphasized the importance of considering jejunal diverticulitis in patients presenting with atypical abdominal pain, particularly when accompanied by other worrisome features such as fever, leukocytosis, and possible abscess formation.

“Prompt diagnosis and appropriate management, including drainage of any abscess and potentially surgical intervention, are crucial for a favorable outcome,” they concluded.

This case underscores the significance of comprehensive diagnostic evaluation in patients with abdominal complaints, as unusual presentations of common conditions can pose a significant diagnostic challenge.

What ​are the common symptoms of jejunal ⁤diverticulitis?

## ​ A Pain in the Gut: Understanding Rare ⁣Jejunal⁢ Diverticulitis

**Host:** ⁣Welcome back to Medically Speaking. Today, we’re discussing a rare condition that landed a 48-year-old man ‌in‌ the emergency room with severe abdominal pain: jejunal diverticulitis. Dr. Smith, thanks for joining ⁣us.

**Dr. Smith:** It’s my pleasure. Jejunal diverticulitis, while⁢ rare, is a condition that can be very serious.

**Host:** Can‌ you ‍explain what⁣ it is and ⁤what causes it?

**Dr. Smith:** Jejunal ‍diverticulitis occurs when small⁢ pouches called diverticula ​form in the jejunum, which is⁢ part of the small intestine. These pouches can ⁤become inflamed and infected,‍ causing pain, and in severe cases, can lead to complications ‍like abscesses⁣ and ​perforations. The exact cause isn’t entirely understood, but factors ‍like ⁢age, diet, and genetics‍ may play a role. [[1](https://www.sciencedirect.com/science/article/pii/S0755498217303688)]

**Host:** ‌This particular case involved pain that was described as “sharp and stabbing,” radiating to the back. What are some of the other common symptoms?

**Dr. Smith:**‍ Jejunal​ diverticulitis symptoms⁢ can mimic other abdominal conditions, making diagnosis tricky. Along⁣ with​ severe ⁢pain, patients‌ may ‌experience nausea, vomiting, fever, and tenderness in the abdomen.

**Host:** This case ‍also involved​ an ‌abscess ‍and perforation. How common are these complications?

**Dr. Smith**: Thankfully, complications like abscesses⁣ and perforations are less common than the inflammation ‌itself.⁤ Thankfully, advanced imaging technologies like multi-detector row ‌computed tomography now allow for​ early detection ⁣and accurate diagnosis of these complications. [[1](https://www.sciencedirect.com/science/article/pii/S0755498217303688)]

**Host:**‌ What’s the takeaway message for viewers?

**Dr. Smith**:‌ If you experience sudden, severe abdominal pain, especially accompanied by symptoms ⁤like fever, nausea, and vomiting, don’t hesitate to seek medical ‍attention. Early diagnosis and treatment are crucial for preventing serious complications like those seen in this rare but impactful case.

**Host:** Thank you for your⁣ expertise, Dr. Smith. This ​serves as a reminder that even rare conditions can be serious, and it’s always ‍better to ⁤err on‌ the ​side of‍ caution when it comes to our health.