Clinical Gastroenterology Vol.31 No.4(5)

Theme Topics of the Gastrointestinal Diverticula
Title Diverticular Disease of the Small Intestine
Publish Date 2016/04
Author Akihito Ehara Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
Author Keigo Mitsui Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
Author Shu Tanaka Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
Author Atsushi Tatsuguchi Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
Author Shunji Fujimori Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
Author Katsuhiko Iwakiri Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine
[ Summary ] Diverticular disease of the small intestine, except for Meckel's diverticulum, is extremely rare. Most cases are acquired diverticula, which lack muscularis propria, and occur most commonly in elderly persons. They are more frequent in the jejunum than in the ileum and emerge on the mesenteric side. They are usually asymptomatic but sometimes cause nonspecific abdominal complications such as bleeding, diverticulitis, perforation, peritonitis, and intestinal obstruction. Appropriate diagnostic imaging modalities should be determined according to the symptom, including radiological enteroclysis, computed tomography (CT), angiography, capsule endoscopy, and balloon endoscopy. For example, surgery can be avoided in case of bleeding by using selective transcatheter embolization or balloon endoscopic procedure for establishing hemostasis. Diverticulitis is successfully treated in most patients with conservative management, although surgery is indicated in cases with perforation, peritonitis, and intestinal obstruction.
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