Jejunal diverticulitis - contained perforation

Case contributed by Wayland Wang
Diagnosis almost certain

Presentation

3 days of left lower quadrant pain. Previous history of sigmoid diverticulitis.

Patient Data

Age: 60 years
Gender: Male

There is a thickened loop of jejunum with a moderate degree of fat stranding affecting the associated mesentery. Small outpouchings are demonstrated arising from the mesenteric border of the jejunum, compatible with small bowel diverticulosis. Several of these are centered in the region of fat stranding. Two gas locules are on the space from the adjacent small bowel. While the larger of these could still represent a diverticulum with intervening wall thickening, the smaller locule is favored to represent extraluminal gas.

Incidental findings include colonic diverticulosis, cortical scarring in the upper pole of the right kidney, small hiatus hernia and atelectasis at the lung bases.

Case Discussion

An example of a contained small bowel perforation due to jejunal diverticulitis.

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