Perforated Jejunal Diverticulitis: A Retrospective Observational Study

Jejunal diverticulitis is a rare but clinically significant cause of abdominal pain that often mimics other intra-abdominal conditions and carries a risk of serious complications, including perforation. Management strategies have varied between conservative treatment with antibiotics and surgical resection, but evidence has remained limited, particularly in small case series.

A single-centre, retrospective observational study was conducted at the Royal Stoke University Hospital (UK). Patients diagnosed with jejunal diverticular perforation (JDP) between January 2012 and March 2025 were identified from the electronic patient record system. Data on demographics, presentation, imaging, treatment, complications, and outcomes were collected. Statistical analysis included descriptive summaries and exploratory comparisons between surgical and conservative management groups using Fisher's exact test, Student's t-test, and Mann-Whitney U test. A two-sided p < 0.05 was considered significant.

Twelve patients were included (mean age 71.5 ± 14.8 years; 75% male). All had undergone contrast-enhanced CT, which demonstrated jejunal diverticulitis with features of perforation in every case. Seven patients (58.3%) were managed surgically, most commonly with segmental jejunal resection and primary anastomosis, while five patients (41.7%) were treated conservatively with intravenous antibiotics and supportive care. Complications occurred in 42.9% of surgical cases and 40.0% of conservative cases, and no mortality was observed in either group.

Jejunal diverticulitis with perforation was an uncommon but important diagnosis that required early recognition and CT imaging for confirmation. Both conservative and surgical management strategies achieved favourable outcomes, and treatment should be guided by clinical stability, response to antibiotics, and suitability for surgery.