Jejunal Diverticulosis: Medical and Surgical Management

McGrew, W; Patel, Jitesh A.; Miller, Perry B.

doi:10.1097/00007611-198505000-00008

Cited by 4 publications

(2 citation statements)

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“…The weakest site is on the mesenteric border where the paired vasa recta penetrate the bowel wall. 3,5,6,9,[11][12][13][14] Because the diverticular wall lacks a muscularis layer, they are classified as pseudodiverticula in comparison to Meckel's and less common congenital diverticula. 9,10 Roughly up to 55 per cent to 80 per cent of diverticula occur in the jejunum, 15 per cent to 38 per cent in the ileum, and 5 per cent to 7 per cent in both.…”

Section: Discussionmentioning

confidence: 99%

“…1-3, 6, 8, 9, 12, 17, 18, 21 It is important to note that asymptomatic pneumoperitoneum is a well-documented finding associated with JID and is not, in and of itself, an indication for surgery. 14,17 Wilcox reported that of 86 patients diagnosed with JID, 15 per cent required operative therapy: 9 four of 13 for massive gastrointestinal bleeding, three of 13 for blind loop syndrome, three of 13 for bowel obstruction, two of 13 for perforation, and one of 13 for chronic pain. 9 In Tsiotos' study, 10 per cent required surgery, although the indications are not clear.…”

Section: The Acute Symptomatic Patientmentioning

confidence: 99%

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Acquired Jejunoileal Diverticulosis and Its Complications: A Review of the Literature

Woods

Williams

Melvin

et al. 2008

The American Surgeon™

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Jejunoileal diverticulosis is a rare entity. Jejunoileal diverticulosis is not a disease that surgeons see often in clinical practice; however, it should remain on the differential diagnosis for any patient with an acute abdomen or gastrointestinal bleeding of unknown origin. It can present with a wide range of clinical scenarios and when patients experience chronic symptoms such as bloating, abdominal pain, nausea, bacterial overgrowth, or malabsorption, medical therapy is successful in most patients. However, when patients present with acute symptoms of bleeding, inflammation, perforation, or obstruction, surgical resection and primary anastomosis is often the treatment of choice. If patients are asymptomatic, they are better left alone, even when discovered incidentally in the operating room. In closing, the possibility of a patient having jejunal diverticular disease should be suspected whenever the symptoms of obscure abdominal pain, anemia, dilated jejunal loops on abdominal radiographs, a history of colonic diverticuli, and a history of acute appendicitis.

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Section: Discussionmentioning

confidence: 99%

Section: The Acute Symptomatic Patientmentioning

confidence: 99%

Acquired Jejunoileal Diverticulosis and Its Complications: A Review of the Literature

Woods

Williams

Melvin

et al. 2008

The American Surgeon™

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Clinical implications of jejunoileal diverticular disease

Longo

Vernava

1992

Diseases of the Colon &Amp; Rectum

166

152

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Congenital and acquired diverticula of the jejunum and ileum in the adult are unusual and occur in approximately 1 percent to 2 percent of the population. They are pulsion diverticula thought to be the result of intestinal dyskinesia. These lesions can produce a significant diagnostic and therapeutic dilemma. They are multiple in the jejunum and solitary distally and are characteristically found in 60- or 70-year-old males. The diagnosis may be confirmed with contrast studies of the small intestine, arteriography, or nuclear scan. Consider these disorders in patients with 1) unexplained gastrointestinal bleeding, 2) unexplained intestinal obstruction, 3) an unexpected cause of acute abdomen, 4) chronic abdominal pain, 5) anemia, or 6) malabsorption. Medical therapy is helpful in controlling diarrhea and anemia, while surgical therapy is reserved for hemorrhage, obstruction, perforation, or failure of medical management. Asymptomatic diverticula discovered on routine contrast studies need not be resected. At surgery, incidental diverticula should be removed when evidence of dilated, hypertrophied loops of small bowel with large diverticula is found. Intraoperative air distention will aid in diagnosis. Resection and primary anastomosis is the preferred treatment for non-Meckelian diverticula. Diverticulectomy is reserved for a Meckel's diverticulum without evidence of ulceration. An incidental Meckel's diverticulum should be removed in the presence of mesodiverticular bands or ectopic tissue. Removal of a Meckel's diverticulum is not advised in the patient with Crohn's disease but may be performed in the patient undergoing restorative proctocolectomy for ulcerative colitis.

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Acquired jejunoileal diverticular disease: subject review.

Maglinte¹,

Chernish²,

Deweese³

et al. 1986

Radiology

108

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Of 519 consecutive patients examined by enteroclysis, 12 (2.3%) were found to have acquired diverticula of the jejunum and ileum. All except one patient had multiple diverticula, most occurring in the jejunum. In only one patient could symptoms be ascribed to the abnormality. The combination of intraluminal distention and extrinsic abdominal compression provided by the enteroclysis technique appears to be the most reliable method for the demonstration of small-bowel diverticula. A discussion of the complications that may result from acquired jejunoileal diverticulosis and a review of the literature are presented.

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Jejunal Diverticulosis: Medical and Surgical Management

Cited by 4 publications

References 0 publications

Acquired Jejunoileal Diverticulosis and Its Complications: A Review of the Literature

Acquired Jejunoileal Diverticulosis and Its Complications: A Review of the Literature

Clinical implications of jejunoileal diverticular disease

Acquired jejunoileal diverticular disease: subject review.

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