Background/Aims: Jejunal diverticulosis (JD) is a rare disease that has a variable presentation. The signs, symptoms, diagnosis, complications and treatment of JD will be discussed through a review of the literature and a series of cases from our own institution. Methods: A retrospective analysis of the diagnosis, treatment and complications of JD was performed by a literature review. This was accompanied by a series of four cases of JD diagnosed and treated in our own institution. Conclusions: JD is a rare disease in which most patients are asymptomatic. However, JD’s different complications are serious and can be fatal. The treatment is mainly surgical; however, there have been cases where nonsurgical management was successful.

This large prospective outcomes study showed that colonoscopy performed by surgeons can be rapidly and successfully done with acceptably low morbidity and mortality. There was no association between experience and complications. However, a minimum of 50 prior colonoscopies and 100 annual colonoscopies were associated with a significant improvement in the rate of completion. There was also a significant correlation between both prior and ongoing annual experience and the time required for the examination. No minimum number of cases can be mandated for credentialing to perform "safe" colonoscopies.

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Restorative proctocolectomy with ileal pouch anal anastomosis has become the most commonly used procedure for elective treatment of patients with mucosal ulcerative colitis and familial adenomatous polyposis. Since its original description, the procedure has been modified in an attempt to obtain optimal functional results with low morbidity and mortality, and yet provide a cure for the disease. These modifications of the technique are discussed in this review, limited to the current points of controversy. We reviewed the current literature describing restorative proctocolectomy with ileal pouch anal anastomosis. The current "hot topics" for debate are transanal mucosectomy with hand-sewn anastomosis versus the double-stapled technique, the use of diverting ileostomy, indeterminate colitis, the role of laparoscopy, and indications for pouch surgery in the elderly. Longer follow-up of patients and increased knowledge and experience with pouch surgery, coupled with active prospective evaluation of the procedure are required to settle these issues. Patients must be fully informed to understand inherent risks of each choice.