Abstract
Background: Jejunal diverticulitis is a rare cause of acute abdomen globally, with even fewer reported cases in African populations, where the condition remains poorly characterised. The non-specific clinical and radiological findings pose considerable diagnostic challenges, particularly in resource-limited settings where advanced imaging may be unavailable.
Objective: To report three patients with perforated jejunal diverticulitis presenting as acute peritonitis, describe the diagnostic challenges encountered, and evaluate surgical outcomes in a resource-limited context.
Case Summary: Three patients presented with an acute onset of severe abdominal pain and clinical signs of peritonitis. Preoperative diagnosis was challenging due to non-specific clinical and radiological findings. Emergency exploratory laparotomy confirmed perforated jejunal diverticulitis in all three cases, managed with segmental bowel resection and primary anastomosis. All patients achieved full recovery with uncomplicated postoperative courses. Histopathological examination confirmed acute diverticulitis with perforation.
Conclusion: Perforated jejunal diverticulitis, while uncommon, should be included in the differential diagnosis of acute abdomen with peritonitis. Early surgical intervention with intestinal resection and primary anastomosis achieves favourable outcomes. This case series highlights the need for increased awareness among surgeons, particularly in African settings, regarding small bowel diverticular disease as a cause of acute abdomen.

Key words: Jejunal, diverticulitis, small bowel, perforation; peritonitis, pseudodiverticula,