Jejunal diverticulitis with perforation

Free perforation of jejunal diverticula occurs rarely; fewer than 50 cases have been reported. Jejunal diverticula are acquired mucosal herniations through the submucosa and muscularis in the upper jejunum along the mesenteric border, near the entrance of segmental blood vessels. In contrast to colonic diverticula, most jejunal diverticula are thin walled and round with a wide, patulous mouth. Frequently, although not always multiple, jejunal diverticula vary greatly in size and may reach a diameter of 10-12 cm. Radiographically detected from small bowel studies in 0.31-0.42% of patients examined, jejunal diverticula are reported in about 1% of autopsies. Most symptomatic patients are men over 60 years old. A 73-year-old black man whose jejunal diverticulum was the site of inflammation and perforation is reported in this study.