Learning objectives
This work aims to provide a thorough and comprehensive literary review of jejunoileal diverticulosis (JID) and its most common complications,
including diverticulitis,
bowel perforation,
hemorrhage and intestinal obstruction,
with emphasis on the medical imaging aspect of diagnosis.
We also present a case series of complicated JID diagnosed in our tertiary referral hospital.
Background
Introduction:
Acquired jejunoileal diverculosis (JID) is a relatively rare clinical entity of elderly people.
The majority of cases are asymptomatic and found incidentally. Only a few cases present with chronic non-specific abdominal symptoms and acute complications,
which include diverticulitis,
perforation,
hemorrhage and intestinal obstruction.
Their relative clinical rarity and varied presentation may make diagnosis both delayed and difficult,
resulting in unnecessary morbidity and mortality. Different imaging techniques can be used to demonstrate small bowel diverticula,
but CT is mostly used if complications are expected.
Clinical...
Findings and procedure details
We retrospectively reviewed 34 cases of complicated JID identified in our tertiary referral hospital between 2010 and 2016 by means of multidetector computed tomography (MDCT),
including 18 women (53%) and 16 men (47%),
aged between 53 - 87 years (mean age of 77 years).
All patients underwent abdominal and pelvic CT examinations because of acute abdominal pain and other symptoms associated. CT images were routinely obtained with the patient in a supine position during full inspiration.
Axial images were obtained at 2mm slice collimations and...
Conclusion
Although complicated JID is an uncommon entity,
it should be considered as a possible cause of acute abdominal pain and lower gastrointestinal bleeding,
usually in elderly patients.
Signs and symptoms of acute complications are nonspecific and the diagnosis will be reached either by an imaging technique or a surgical exploration.
Most complications of JID require surgery resecting the intestinal segment with diverticula.
However,
if recognized early,
surgery may be avoided in lieu of conservative treatment.
Since complications can be severe,
awareness of imaging features and...
Personal information
This work comes from the Radiology Department of:
Hospital Universitari Vall d'Hebron
Psg.
Vall d'Hebron 119-129
08035 BARCELONA (SPAIN)
e-mail adress of the first author:
[email protected]
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