Small Intestinal Nonmeckelian Diverticulosis

Abstract

Nonmeckelian jejunoileal diverticula (JID) are rare, but potentially clinically significant lesions. Despite recent advances in modern diagnostic modalities, diagnosis of JID may be problematic. Upper gastrointestinal contrast series with small bowel follow-through examination and mainly enteroclysis are the 2 main diagnostic methods. In selected cases (mainly complicated JID), the physician could use other diagnostic methods, such as ultrasound, computed tomography, endoscopy, intraoperative endoscopy, laparoscopy, radiotagged erythrocyte bleeding scans, and selective mesenteric arteriography. JID may be clinically silent or symptomatic causing chronic pain or malabsorption or other acute complications, such as hemorrhage, inflammation, perforation, etc. Laparotomy remains the gold standard for definite diagnosis of asymptomatic and complicated diverticula. Treatment should be individualized. Surgery could be indicated, mainly in symptomatic diverticula. The extent of resection may be a problem, especially in patients with extensive disease involving large parts of the bowel. In these cases, clinical judgment is required from the part of surgeon to avoid short bowel syndrome.

One of the Rare Causes of Acute Abdomen Leading to Subileus: Jejunal Diverticulitis

“…Jejunal diverticulosis was first defined as herniation of the mucosa and the submucosa from the inside of the muscular layer of the bowel wall on the mesenteric side of the intestine in 1794 by Sommering and later in 1807 by Sir Asley Cooper (1,3). Jejunal diverticula are detected in autopsy series at rates ranging from 1.3% to 4.6%, whereas the rate of radiological detection is between 0.02% and 2.3% (4,5).…”

Rare Coexistance of Ileal Diverticulosis, Crohn’s Disease and Small Bowel Adenocarcinoma: Report of a Case

“…Although it has been suggested that some JID may be congenital (solitary diverticula in young patients may represent partial reduplication of the small bowel), it is now widely accepted that most of these lesions are acquired. The pathogenesis seems to be multifactorial (16).…”

“…Laparoscopy, radiotagged erythrocyte bleeding scans and selective mesenteric arteriography can be performed as well. Laparotomy remains the gold standard for definite diagnosis of asymptomatic and complicated diverticula (16).…”

Perforation of Jejunal Diverticulosis: Rare Cause of Peritonitis

“…Jejunal diverticula are rare with 1% prevalence in the general population [1]. Small bowel diverticula occur most frequently in the duodenum (45%), followed by Meckel's diverticulum (23%).…”