Jejunal diverticulosis: complications and management - a case series

Area of Science:

• Gastroenterology
• Surgical Gastroenterology

Background:

• Jejunal diverticulosis (JD) is an uncommon condition with a low incidence, typically affecting the elderly.
• While often asymptomatic, JD can lead to severe complications, including diverticulitis, perforation, obstruction, and gastrointestinal bleeding, presenting diagnostic and management difficulties.

Observation:

• This case series details five patients with complicated JD.
• Four patients presented with jejunal diverticulitis, two of whom experienced free perforation necessitating emergency surgery, while the other two had chronic inflammation.
• The fifth patient suffered from severe gastrointestinal bleeding that was not detected by conventional endoscopy, requiring advanced diagnostic methods.

Findings:

• Three patients with diverticulitis underwent successful segmental resection.
• One patient with diverticulitis was managed conservatively.
• The patient with gastrointestinal bleeding responded favorably to conservative management, avoiding surgical intervention.

Implications:

• Complicated JD can lead to life-threatening situations.
• Clinicians should consider JD in elderly patients presenting with acute abdominal symptoms or obscure gastrointestinal bleeding.
• Prompt diagnostic imaging and individualized treatment strategies are essential for improving patient outcomes and highlight the need for increased awareness of JD in differential diagnoses.