Jejunal diverticulum enterolith causing perforation and upper abdominal peritonitis.

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.