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Jejunal diverticulum enterolith causing perforation and upper abdominal peritonitis.

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A perforated jejunal diverticulum caused by an enterolith led to acute abdominal pain and small bowel obstruction. Surgical resection and washout resulted in a full recovery, highlighting the importance of considering these complications in acute abdomen cases.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Abdominal Imaging

Background:

  • Jejunal diverticula are uncommon outpouchings of the small intestine.
  • Complications such as perforation and enterolith formation are rare but serious.
  • Acute abdomen presentations require prompt diagnosis and management.

Observation:

  • A patient presented with acute upper abdominal pain, localized peritonitis, elevated inflammatory markers, and lactate.
  • CT scan revealed a calcified mass, mesenteric volvulus, and small bowel obstruction.
  • Laparotomy identified multiple jejunal diverticula with one perforated by an enterolith.

Findings:

  • Perforation of a jejunal diverticulum due to an enterolith caused acute abdominal symptoms.
  • Mesenteric volvulus and small bowel obstruction were secondary complications.
  • Surgical intervention involving resection and washout led to patient recovery.

Implications:

  • Jejunal diverticula and enteroliths should be considered in the differential diagnosis of acute abdomen.
  • Early recognition and surgical management are crucial for favorable outcomes.
  • This case underscores the potential severity of jejunal diverticular disease.