Acquired jejuno-ileal diverticular disease: a diagnostic and management challenge

Abstract

Background: Acquired jejuno-ileal diverticular disease (JID), a result of abnormalities in the smooth muscle or myenteric plexus of the small bowel, is less rare than was once believed. Approximately 1.3% of the population has JID, of whom approximately 10% present with life-threatening complications such as inflammation, perforation, bleeding, obstruction and malabsorption. Jejuno-ileal diverticular disease can be diagnostically and therapeutically challenging, and complications are often diagnosed only at laparotomy, while the best management is not agreed on in the literature. To increase the awareness of this condition and its complications, the Auckland Hospital's experience of JID was reviewed.

Methods: Retrospective review was carried out of the audit data and the discharge coding records of Auckland Public Hospital for the 5 year period leading to November 2001.

Results: Nine cases with a variety of presentations were found. Those cases are described and a literature review of JID is provided.

Conclusion: Jejuno-ileal diverticular disease should be included in the differential diagnosis when dealing with surgical emergencies in the elderly presenting with features of bowel perforation, obstruction or bleeding.