NON-SURGICAL MANAGEMENT OF PERFORATED JEJUNAL DIVERTICULUM

Jejunal diverticulitis complicated by perforation is rare and shows an uncharacteristic presentation and thus poses a difficulty in the early diagnosis ofthe condition.However, diverticulitis and its complications should always be considered in geriatric men who present with an acute abdomen. We describe a 77-year-old man who originally presented with acute abdominal pain having free gas under right dome of diaphragm on X-ray abdomen, upon further evaluation with CT abdomen, a diagnosis of contained jejunal diverticular perforation was made.Onceoptimized he was then managed non-operatively with intravenous fluids, antibiotics, and total parenteral nutrition and supportive care. His overall recovery during hospitalization was uneventful. A follow-up CT abdomen showed no new pocket of fluid or free air. As jejunal perforation is a rare finding, early laparotomy done based upon free gas on X-ray alone may be correlated with an overall higher risk of mortality due to the diseases proximity to duodenojejunal flexure and thus conservative management in selected group of patients may prevent inadvertent celiotomy and morbidity and mortality arising out of it.