The clinical significance of acquired jejunoileal diverticula

Objective: Because of the relative rarity of acquired jejunoileal diverticulosis, including its symptomatology and complications, diagnosis is often difficult and delayed, resulting in unnecessary morbidity and mortality. The purpose of the present study was to draw attention to jejunoileal diverticula and their complications as a site of gastrointestinal symptoms. Methods: The records of 10 patients with symptomatic jejunoileal diverticula treated in our departments were reviewed. Results: The clinical presentation was varying and nonspecific, Jejunoileal diverticula were diagnosed peroperatively in four patients operated on successfully for their acute complications. In one case the diagnosis was considered after a radiotargeted erythrocyte bleeding scan and in five other cases enteroclysis for chronic abdominal complaints demonstrated jejunoileal diverticula, The death of one patient operated on for massive hemorrhage from jejunal diverticula was probably related to delayed diagnosis and treatment. Conclusions: Jejunoileal diverticula should not always be dismissed as asymptomatic findings, as they may be the cause of vague, chronic symptomatology and acute complications, including intestinal obstruction, hemorrhage, and perforation. Awareness of the fact that jejunoileal diverticula may cause chronic nonspecific abdominal symptoms and serious acute complications may lead to earlier diagnosis and timely treatment with lower morbidity and mortality. (C) 1998 by Am. Coll. of Gastroenterology.