Abstract
A 77-year-old man presented to our hospital because of a one-day history of lower abdominal pain. He had no history of peptic ulcer disease. Physical examination showed lower abdominal tenderness and rebound tenderness without muscular rigidity. Abdominal CT scan revealed a small amount of free air in the abdominal cavity probably caused by perforation of the upper gastrointestinal tract, but the exact location of the perforation was not clear. An emergent operation was performed using laparoscopic assisted procedure. A perforated jejunal diverticulum was found to be about 20cm distal from the ligament of Treitz, and partial resection of the jejunum, peritoneal lavage and drainage were performed. Pathological findings revealed a perforation of pseudo-diverticulum. Laparoscopic procedure was useful to detect the location of perforation which was unclear before the operation. Perforation of a jejunal diverticulum is rare and difficult to be diagnosed before surgery, however, we should suspect it in the case of perforation of the gastrointestinal tract.
