Year: 2026 | Month: May | Volume: 16 | Issue: 5 | Pages: 237-242
DOI: https://doi.org/10.52403/ijhsr.20260527
Jejunal Diverticular Perforation: A Case Series of a Rare Complication Seen in Geriatrics in Tertiary Care Centre in South Maharashtra
Rahul Patil1, Moses Ingty2, Rohit Desai3
1Senior Resident, Department of General Surgery, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India.
2Professor, Department of General Surgery, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India.
3Assistant Professor, Department of General Surgery, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India.
Corresponding Author: Dr. Rahul Patil
ABSTRACT
Jejunal diverticulosis is a rare acquired disorder of the small intestine caused by abnormalities in smooth muscle or myenteric plexus function, resulting in increased intraluminal pressure and subsequent mucosal–submucosal herniation through weak points in the bowel wall. Although the condition is frequently asymptomatic, particularly in younger individuals, it may occasionally present with chronic nonspecific gastrointestinal symptoms or severe complications such as diverticulitis, intestinal obstruction, hemorrhage, and perforation. Among these, perforation is uncommon but associated with considerable morbidity and mortality due to delayed diagnosis and vague clinical presentation.
We report a series of five geriatric patients managed at a rural tertiary care centre in southern Maharashtra between 2020 and 2025. The patients presented with features of acute abdomen including abdominal pain, distension, vomiting, constipation, and signs of localized or generalized peritonitis. Laboratory investigations revealed leukocytosis in all cases, while radiological evaluation demonstrated findings such as pneumoperitoneum, interbowel collections, bowel wall thickening, and inflammatory changes suggestive of small bowel perforation. Contrast-enhanced computed tomography proved to be the most valuable diagnostic modality in identifying the pathology preoperatively.
Emergency exploratory laparotomy was performed in all patients. Intraoperatively, multiple jejunal diverticula with perforation along the mesenteric border were identified, associated with varying degrees of purulent or feculent contamination. Segmental jejunal resection with primary jejunojejunal anastomosis was performed in all cases. Four patients had uneventful postoperative recovery, while one patient developed a burst abdomen during the postoperative period. No mortality was observed in this series. This case series emphasizes the importance of maintaining a high index of suspicion for jejunal diverticular perforation in elderly patients presenting with acute abdomen. Early radiological evaluation and prompt surgical intervention remain crucial in reducing morbidity and improving outcomes in this rare but potentially life-threatening condition.
Key words: Jejunal diverticulosis, Diverticular perforation, jejunal diverticulitis.