Small bowel diverticulitis

Case contributed by Dr Yair Glick

Presentation

Left lower abdominal pain for past several days. Mentions partial colectomy several years ago in a different country.

Patient Data

Age: 75 years
Gender: Male
CT

Large jejunal diverticula at level of left kidney and below. Focal eccentric bowel wall thickening and adjacent fat stranding around an extramural gas bubble that could either represent a diverticulum or diverticular perforation.

Surgical anastomosis in sigmoid colon (adjacent to contrast-filled small bowel loop).
Tiny hypodense focus in hepatic segment 3.
Shrunken gallbladder containing small calcified stones.
Small cortical cysts in both kidneys, peripelvic cyst in left kidney.
Vertical midline scar in abdominal wall, circumnavigating the umbilicus. Small umbilical hernia containing short loop of small bowel. Small incisional hernia right above it, containing very short loop of small bowel. No evidence of strangulation/obstruction in either hernia.
Small right inguinal hernia containing fat.

Case Discussion

The patient left the emergency room against medical advice; the idea was to admit him for IV antibiotics and supervision.

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