Jejunal diverticulum is a rare condition (0.06-2.3% of all intestinal diverticula), being more frequent in the proximal jejunum. It is more common in males, between the sixth and seventh decade of life. It is usually diagnosed accidentally on the operating table during an exploratory laparotomy or as a postmortem finding. It can also be diagnosed through the use of media such as computerized tomography images of the abdomen, endoscopy or in case of bleeding by angiography. Complications are always treated surgically. The management of incidental findings being controversial. We report the case of a patient, male, 63 years old with previous peptic ulcer disease treated with conservative management, who presented to Emergency Hospital Dr. Adolfo Pons, Maracaibo IVSS for presenting clinical picture of abdominal pain of seven hours of evolution and of epigastric predominance, without irradiation, moderate intensity associated with vomiting twice, no bowel movements and flatus. Hemodynamically stable patient with mucocutaneous pallor, febrile, dehydrated, eupneic, tachycardic. Abdomen with widespread pain on palpation especially in the periumbilical region (epigastric), no bloating, no masses or organomegaly, with muscular defense but no signs of peritoneal irritation, bowel sounds present. He was admitted with the diagnosis of acute abdomen: perforated peptic ulcer, so it was decided to conduct an exploratory laparotomy. Surgical findings were a large dilated stomach, duodenum and proximal jejunum also approximately 500 cc purulent free cavity jejunal diverticulum perforation with intestinal fluid outlet and purulent fibrinous membranes, multiple jejunal diverticula in the mesenteric border, 50 cm from the ligament of Treitz. A resection of the involved segment of jejunum, approximately 40 cm, with end to end anastomosis was performed. Pathologic examination of the surgical specimen, comfirmed the diagnosis of jejunal diverticulosis The patient recovered satisfactorily.
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