Jejunal Diverticulitis With Contained Perforation and Abscess Successfully Managed With Conservative Therapy: A Case...

Jejunal diverticulosis is a rare condition that predominantly affects elderly individuals and is often asymptomatic. However, complications such as diverticulitis, perforation, and abscess formation can result in significant morbidity. Perforated jejunal diverticulitis has traditionally been managed surgically, although increasing evidence supports conservative treatment in selected patients. We report a case of a 74-year-old female with hypothyroidism, hyperlipidemia, and Alzheimer's dementia who presented with acute bilateral lower abdominal pain and nausea. Laboratory evaluation demonstrated leukocytosis, elevated inflammatory markers, and lactic acidosis. CT of the abdomen and pelvis revealed jejunal diverticulitis with focal perforation and an adjacent 2.4 × 3.6 cm gas-containing abscess. Given her hemodynamic stability and absence of generalized peritonitis, she was managed nonoperatively with bowel rest, IV fluids, ceftriaxone, and metronidazole. The patient improved clinically with normalization of inflammatory markers and was discharged on oral antibiotics. Follow-up imaging demonstrated complete resolution of the abscess and eventual resolution of inflammatory changes without surgical intervention. This case contributes to the growing body of evidence supporting conservative management of contained perforated jejunal diverticulitis and highlights the importance of careful patient selection and longitudinal radiographic follow-up.