Rare forms of small intestinal diverticulum and diagnostic features. A clinical case report.

INTRODUCTION: Small intestinal diverticulosis is a rare pathology compared with colonic diverticular disease and is often characterized by nonspecific clinical manifestations. Diagnostic difficulties increase significantly in emergency surgery, especially when diverticulitis mimics other acute abdominal conditions. OBJECTIVE: To present a clinical case of jejunal diverticulosis complicated by diverticulitis and intestinal paresis, highlighting the diagnostic challenges encountered in emergency surgical practice. MATERIALS AND METHODS: A retrospective analysis of the clinical course, diagnostic findings, surgical treatment, and outcomes of a 69-year-old patient admitted with a presumed diagnosis of perforated gastric ulcer was performed. RESULTS: The patient was hospitalized with acute abdominal pain, nausea, vomiting, and signs of peritoneal irritation. Laboratory examination revealed moderate leukocytosis. Plain abdominal radiography demonstrated dilated small bowel loops. Emergency laparotomy revealed serohemorrhagic peritoneal effusion, signs of acute pancreatitis, and multiple diverticula along the mesenteric border of the jejunum extending approximately 1 m from the ligament of Treitz. No evidence of perforation was found. The final diagnosis was jejunal diverticulosis complicated by diverticulitis and paralytic ileus. Conservative postoperative management, including antibacterial, detoxification, antiulcer, and symptomatic therapy, resulted in complete recovery. The patient was discharged in satisfactory condition on postoperative day 10. CONCLUSION: Jejunal diverticulosis may present as acute abdominal pathology and mimic intestinal obstruction or perforated peptic ulcer. Accurate diagnosis remains challenging due to nonspecific clinical and instrumental findings. In emergency settings, surgical exploration remains the most reliable diagnostic method, allowing appropriate assessment of disease severity and selection of optimal treatment strategy. The presence of small intestinal diverticulosis without perforation or severe complications does not necessarily require bowel resection.