Rare Cause of Left Upper Abdominal Pain

• Main Authors: Bibiana Aiyegbeni, Saleem Jonnalagadda, Lee Creedon, Aija Teibe
• Format: Article
• Language: English
• Published: Karolinum Press 2021-06-01
• Series: Prague Medical Report
• Subjects: jejunal diverticulitis; diverticular disease; acute abdomen; duodenal diverticulum
• Online Access: https://pmr.lf1.cuni.cz/122/2/0106/

Inflamed diverticular disease of the small bowel is an uncommon cause of acute abdominal pain. Despite its low prevalence rate (0.3–2%), it is associated with a high mortality rate between 20–25% (Fisher and Fortin, 1977; Ferreira-Aparicio et al., 2012). This is due to complications including perforation, bleeding, and obstruction. This case report presents the diagnosis and management of Mr. X, a 70-year-old male with jejunal diverticulitis and a duodenal diverticulum. Mr. X has a background of type 2 diabetes mellitus and sigmoid diverticulosis, he presented with a three-day history of left upper quadrant pain radiating to the left iliac fossa. He was haemodynamically stable despite his elevated inflammatory markers (C-reactive protein 161 mg/l and neutrophils 13.3×109/l) and computerised tomography (CT) of the abdomen and pelvis showing jejunal diverticulitis and a duodenal diverticulum. Mr. X was successfully treated with intravenous antibiotics and analgesia and a follow up CT scan showed that the jejunal diverticulitis had resolved. Previous operative management of the discussed pathology has been reported, the current report is novel as the diagnosis was made early and the case managed conservatively.