Perforated Jejunal Pseudodiverticulum Managed With Limited Segmental Resection: A Case Report

Jejunal diverticulitis (JD) is a rare disease with significant clinical relevance, as it often causes intense pain in the epigastrium that radiates to the left flank, accompanied by hemodynamic instability and leukocytosis. Diagnosis must be complemented with clinical and imaging studies.  A 72-year-old woman presented with abdominal pain of colic type in the epigastrium and left flank for 12 hours. The computed tomography scan showed two diverticula in the jejunum, the first with localized pneumoperitoneum and signs of perforation, the second with no signs of an inflammatory process. An exploratory laparotomy was indicated, identifying perforation of a diverticulum. Jejunal resection and primary anastomosis were performed. The postoperative period was uneventful, with no complications at 30-day follow-up. JD is an uncommon pathology with high morbidity due to its diagnostic difficulty. There are no established guidelines for the treatment of this pathology, however medical management with a broad-spectrum antibiotic approach, accompanied by intravenous fluid resuscitation, has proven effective in stabilizing vital signs and laboratory parameters of patients, which favors the clinical status and outcome of subsequent surgery. Upon perforation, definitive surgical management is needed.