Acute Jejunal Diverticulitis: A Case Report.
Cureus 2026 Jan; 18(1):e101609.

Abstract

Acquired small intestinal diverticulitis and its complications remain poorly understood due to their rarity and nonspecific presentation. Complications such as abdominal sepsis, bleeding, and perforation can lead to unfavorable outcomes. We report the case of a patient who presented with acute jejunal diverticulitis requiring surgical intervention. A 66-year-old man with a history of endovascular abdominal aortic aneurysm repair presented with acute left lower quadrant abdominal pain and tenderness. Computed tomography (CT) detected intestinal diverticulosis, localized free air, and inflammatory changes associated with the small intestine. Exploratory laparoscopy revealed numerous proximal jejunal diverticula with perforation contained within the mesentery. A 48 cm segment of the jejunum was resected, and a primary anastomosis was performed. Surgical pathology confirmed acute small intestinal diverticulitis and serositis. The patient had an uneventful postoperative course and was discharged home on postoperative day 6. This case highlights the diagnostic challenge in acute small intestinal diverticulitis, which may present with nonspecific signs and inconclusive radiological findings. The location of diverticula along the mesenteric border may contain perforations in the mesentery and obscure peritoneal signs. Although some patients with acute small intestinal diverticulitis may be conservatively managed, surgical intervention remains the standard of care for managing patients with complications. Acute small intestinal diverticulitis, though exceedingly rare, can carry a significant risk of morbidity and mortality. Thus, small intestinal diverticulitis should be considered in the differential diagnosis in older adults who present with acute abdominal pain and tenderness. Surgical management remains the gold standard of treatment of severe acute small intestinal diverticulitis.

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Authors+Show Affiliations

Sedivy RDepartment of Surgery, University of Minnesota, Minneapolis, USA.
Nigam ADepartment of Surgery, University of Minnesota, Minneapolis, USA.
Meshram PDepartment of Surgery, University of Minnesota, Minneapolis, USA.
Naaz RDepartment of Surgery, Shadan Institute of Medical Sciences, Hyderabad, IND.
Onongaya CDepartment of Surgery, University of Minnesota, Minneapolis, USA.
Park BUDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, USA.
Nguyen SHDepartment of Surgery, University of Minnesota, Minneapolis, USA.
Harmon JVDepartment of Surgery, University of Minnesota, Minneapolis, USA.
McCormick-Deaton JDepartment of Surgery, University of Minnesota, Minneapolis, USA.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

41700270