Jejunal diverticulosis causing intestinal obstruction in a middle-aged man: a rare case emphasizing coexistence and potential association with colorectal carcinoma

Sep 29, 2026

Jejunal diverticulosis is an uncommon condition that is often asymptomatic but may progress to serious complications including intestinal obstruction. This case report describes a 45-year-old man with abdominal distension, vomiting, and colicky pain, where imaging identified multiple jejunal diverticula causing small bowel obstruction and an incidental cecal mass suspicious for malignancy. Exploratory laparotomy confirmed jejunal diverticula with ischemia and a firm cecal growth. Diverticulectomy with segmental resection and right hemicolectomy were performed; recovery was uneventful after discharge on day seven.

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CategoryHealthcare

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Introduction

Case Presentation

Clinical Discussion

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Case Report Jejunal diverticulosis causing intestinal obstruction in a middle-aged man: a rare case emphasizing coexistence and potential association with colorectal carcinoma Hafiz Muhammad Hamza, MBBSa , Muhammad Muiz Malik, MBBSb , Naveed Ullah Khan, MBBSc , Muhammad Daoud Tariq, MBBSb , Ayaz Ahmed Awan, MBBSb , Deepak Rai, MBBSd ,* Introduction: Jejunal diverticulosis is a rare condition that usually remains asymptomatic but can occasionally lead to serious complications such as obstruction, perforation, or bleeding. Its vague presentation often delays diagnosis. In exceptional cases, it may coexist with other intra-abdominal pathologies such as colorectal malignancy, complicating both diagnosis and management. Case Presentation: A 45-year-old male presented with 5 days of abdominal distension, vomiting, and colicky pain. Imaging revealed small bowel obstruction due to multiple jejunal diverticula and an incidental cecal mass suspicious for malignancy. Exploratory laparotomy confirmed multiple large jejunal diverticula with an epiploic adhesion band causing proximal jejunal ischemia, along with a firm cecal growth consistent with the CT findings. Diverticulectomy with segmental jejunal resection and right hemicolectomy were performed. The patient declined postoperative oncologic consultation and further histopathological evaluation of the cecal mass. His postoperative recovery was uneventful, and he was discharged on the seventh day. Clinical Discussion: This case underscores the diagnostic complexity of jejunal diverticulosis presenting with intestinal obstruction, further complicated by a concurrent cecal mass. Surgical management was directed at resolving the obstruction and ensuring oncologic safety through resection. Such scenarios highlight the importance of individualized intraoperative judgment, especially when patient preferences limit further investigation and treatment. Conclusion: Jejunal diverticulosis should be considered in unexplained small bowel obstruction. When an incidental mass is encountered intraoperatively, simultaneous resection is justified, particularly if oncologic follow-up is uncertain. Early surgical intervention remains key to preventing ischemic complications and achieving favorable outcomes. Keywords: case report, diverticulectomy, intestinal obstruction, jejunal diverticulosis, small bowel ischemia Introduction Jejunoileal diverticulosis (JD) is a rarely occurring disorder that comprises herniation of mucosal layers through the weakened areas in the muscularis mucosae. The complications include obstruction, malabsorption, diverticulitis, bleeding, and perforation[1] . Obstruction may be secondary to volvulus, enterolith impaction, intussusception, or adhesions, with the aDepartment of General Surgery, Foundation University Medical College, Islamabad, Pakistan, bDepartment of Internal Medicine, Foundation University Medical College, Islamabad, Pakistan, cSurgery, Federal Government Polyclinic Hospital Islamabad, Islamabad, Pakistan and dDepartment of Internal Medicine, Amppipal Hospital, Gorkha, Nepal Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. *Corresponding author. Address: Department of Internal Medicine, Amppipal Hospital, Gorkha 34000, Nepal. Tel.: +977984992 5192. [E-mail: deepakrai9812@gmail.com](E-mail: deepakrai9812@gmail.com) (D. Rai). Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This isan open access article distributed under the terms of the Creative Commons AttributionNon Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Annals of Medicine & Surgery (2026) 88:804–808 Received 9 June 2025; Accepted 1 November 2025 Published online 24 November 2025 [http://dx.doi.org/10.1097

FAQs

Why is jejunal diverticulosis diagnosis often delayed in this case?

Jejunal diverticulosis usually remains asymptomatic and has vague, nonspecific presentations, which can postpone diagnosis until complications occur or during imaging/operations.

What findings led to the diagnosis of intestinal obstruction in the patient?

A 45-year-old man presented with abdominal distension, vomiting, and colicky pain. Imaging revealed small bowel obstruction due to multiple jejunal diverticula and an incidental cecal mass suspicious for malignancy.

How was the surgical management planned when a cecal mass was incidentally found?

Surgical management focused on resolving the obstruction and addressing oncologic safety through resection. The case emphasizes that simultaneous resection is justified when an incidental mass is encountered and oncologic follow-up is uncertain.

Sep 29, 2026

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