PMC7479310_01
CT of the abdomen in a 78-year-old man with increasing abdominal pain over approximately 6 h. The CT scan shows whirling of the mid-abdominal mesentery with edematous changes of the fat and congestive prominence of mesenteric vessels amongst small bowel loops at this level. Early small bowel obstruction was seen with transition point in the left lower abdomen.
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It showed a "whirling" of the small bowel mesentery with edematous changes concerning for volvulus (Fig. 1).
Jejunal diverticulum seen at the time of exploratory laparotomy prior to resection. The outpouching of the bowel wall occurs at its mesenteric border.
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Pictures of the solitary jejunal diverticulum in-situ were taken (Fig. 2).
Resected specimen of the jejunal diverticulum. The diverticulum was removed with approximately 15 cm of bowel on each side of the diverticulum.
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A generous resection of the diverticulum including an approximate 30 cm segment of the jejunum was performed (Fig. 3).
(top). Histopathologic sections through apex of the false diverticulum. The wall is composed of mucosa, muscularis mucosa and submucosa. The muscularis mucosa and submucosa show large dilated blood vessels. The muscularis propria, both circular and longitudinal layers are absent. Fig. 4 (bottom). Histopathologic section through the small bowel adjacent to but not within the diverticulum. All layers of the jejunal wall are intact including muscularis propria (Hematoxylin and eosin, 2x).
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This confirmed that this was a false diverticulum where mucosa and submucosa were present in the outpouching in the absence of a surrounding layer of smooth muscle (Fig. 4).