Jejunal diverticulitis is a rare entity with a higher prevalence among patients between 60 and 70 years. Jejunal diverticula are most often considered an incidental finding, but, they can have complications such as diverticulitis, perforation, abscess, generalized peritonitis, fistula, obstruction and bleeding.Setting the diagnosis still remains challenging. Physicians should be aware of their existence and the clinical suspicion should be raised, especially in the setting of acute abdominal pain where jejunal diverticulitis should be included in the differential diagnosis. A small amount of free air adjacent to the small bowel can be confusing and easily misdiagnosed as small bowel perforation, but, it can actually be found as a result of the inflammation itself without macroperforation or complications.This fact can change the therapeutic strategy to less aggressive, conservative treatments. We present a case of a patient coming to the emergency department with acute abdominal pain, signs of peritonitis, a small amount of extraluminal air, and jejunal diverticulitis without perforation was diagnosed on laparotomy, and a review of the current literature.

Colovaginal and colo-ovarian fistulas are rare entities that could be attributed to diverticular disease after an episode of acute diverticulitis. Τhey could initially be manifested with symptoms that lead patients to the gynecologist. Gynecologists should consider them in the differential diagnosis, especially after recurrent episodes of sinusitis. We report the case of a 51-year-old woman with a colovaginal and a colo-ovarian fistula due to subclinical diverticular disease, which should be involved in the differential diagnosis in those complicated fistulas, even if the patient had never before a clinical episode of acute diverticulitis or known diverticular disease, and a successful surgical approach.