Non-Surgical Management for Abdominal Abscess due to Penetrated Jejunal Diverticulitis—Report of a Case—

Abstract

Jejunal diverticulum is rare. It is often asymptomatic, but sometimes presents with symptoms such as diverticulitis. When it causes abdominal abscess or peritonitis due to penetration or perforation of jejunal diverticulitis, surgical therapy is selected in many cases and there are few cases treated conservatively. We have experienced a case of abdominal abscess caused by jejunal diverticulitis treated conservatively.

A 70-year-old woman presented to our hospital with fever and left lower quadrant abdominal pain. An abdominal CT scan revealed multiple jejunal diverticula, mild degree of thickening wall and a jejunal diverticulum with enhancement effect. We identified fluid retention with air and the increased CT value of panniculitis in the mesentery which was adjacent to the diverticulum. We diagnosed the case as abdominal abscess and localized peritonitis due to penetrated jejunal diverticulitis. Since her general condition was stable and the abdominal symptom was localized, we selected conservative therapy and she made a good recovery. From our experience as well as previous reports, we can afford to select conservative therapy if the correct diagnosis of penetrated jejunal diverticulitis is made early after the onset of the disease and patient's general condition is stable.