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Background Multiple small-bowel diverticulosis comprises a rare entity with probable underestimated incidence, and that may be the reason why it is sometimes overlooked when managing cases with peritonitis. Case report In the present paper, we report the case of a 76-year-old male presenting abdominal pain and fever in an acute setting. Computed tomography (CT) scans revealed jejunal thickening and numerous images of saccular addition that were interpreted as jejunoileal diverticulitis. After an initial period of clinical treatment, surgical management was indicated based on a worsening clinical picture and the presence of an extraluminal focus of gas detected in a subsequent CT scan. Through a laparoscopic approach, multiple small-bowel diverticula and a tamponade perforation were found. A segmental intestinal resection was performed, and the patient was discharged after a ten days. Conclusions Multiple jejunal diverticulosis is a rare condition that should be remembered in the setting of an acute abdomen. As it prevails among older patients, early diagnosis with radiological aid is crucial to establish the most adequate management, including intestinal resection, if necessary.

Small bowel diverticular disease occurs in 0.3% to 20% of the population and is much less common than large bowel diverticular disease, which is present in 15% to 40% of adults. Of those with small bowel diverticula, only 4% will develop symptoms. Despite these relatively low statistics, it is nevertheless important for the general surgeon to have a firm understanding of small bowel diverticular disease when considering the broad differential diagnoses of abdominal pain and gastrointestinal bleeding. Three types of small bowel diverticula warrant particular consideration: duodenal diverticula, jejunoileal diverticula, and Meckel diverticula. The most frequently encountered diverticula are duodenal (45%), compared to jejunoileal (25%) and Meckel diverticula (25%), and jejunoileal diverticula are most often symptomatic. This chapter discusses each type of diverticula and its epidemiology, pathogenesis, clinical presentation, diagnosis, and management.

The objective of this study is to discuss the presentation and diagnosis of a complicated jejunoileal diverticuli.The case of a 94-year-old woman with small bowel obstruction secondary to an impacted enterolith from a jejunoileal diverticulum is presented to illustrate the clinical picture and radiographic findings of complicated small bowel diverticula.

Acquired diverticula of the jejunum and ileum are uncommon and asymptomatic in the majority of patients. They should not always be dismissed as an incidental finding, because they may be the cause of vague, chronic symptomatology. Acute complications, including intestinal obstruction, hemorrhage and perforation, are rare, but may necessitate immediate surgical intervention. Due to the relative rarity of these lesions and their complications, diagnosis is often difficult and delayed. The high mortality of the acute complications is related to delayed diagnosis and the advanced age of the patients. Four cases with complications of jejunoileal diverticulosis and three cases of asymptomatic jejunoileal diverticula are presented and the literature is reviewed.

Small bowel diverticulitis is most commonly characterized by inflammation of acquired diverticula which are typically located on the mesenteric border of the bowel. Although less frequent than duodenal diverticula, jejunoileal diverticula are more prone to develop complications, including acute inflammation with perforation and abscess formation. The current mode of treatment for small bowel diverticulitis is either with conservative medical management or surgical resection of the involved segment of bowel.

Jejunoileal diverticula can be divided into two broad categories: congenital, present at birth and related to abnormalities of embryologic development, such as Meckel’s diverticulum, and acquired, which include all others, especially when diffuse and with presentation in adulthood.

Jejunoileal diverticula is a uncommon clinical condition seen in sixth and seventh decades of life and incidence being from 0.02% to 1.3% in general population. Here a rare case of jejunoileal diverticula observed incidentally during surgery for a suspected case of mesenteric cyst is being reported. A 62 year old lady was admitted to our hospital with history of pain abdomen was evaluated for pain abdomen. The biochemical parameters were within normal limits, abdominal ultrasound and computed tomography were suggestive of mesenteric cyst. On exploration jejunal mesenteric cyst was found and excised. Incidentally multiple jejunal and ileal diverticula were noticed along mesenteric borders and were left alone without any surgical intervention. Post operative recovery was uneventful. The aim of this case report is to show the rarity of the condition with review of the literature.

Non-Meckelian jejunoileal diverticula are more frequently diagnosed in men aged more than 50 years old. They are a rare cause of acute abdomen. They are usually asymptomatic and are estimated to cause complications in 10-20% of cases. We present the recently diagnosed case of an 82-year-old man admitted to our hospital.

Hemorrhage from a non-Meckelian jejunoileal diverticulum is rare, and it is generally difficult to diagnose the source of the bleeding. Here, we report the case of a 59-year-old male with hemorrhage from an ileal diverticulum. Contrast computed tomography scans demonstrated the ileal diverticulum and extravasation of the contrast medium around it. The diagnosis was then made by computed tomography scans, and endoscopic mechanical hemostasis was performed under colonoscopy with three metal clips. The management of hemorrhage from jejunoileal diverticula is discussed.

Figure 1. Multiple Jejunoileal Diverticula. An 82-year-old man with a one-year history of diarrhea, steatorrhea (20 g of fat per day), and massive weight loss (20 kg) was suspected of having pancreatic carcinoma. The results of gastroduodenoscopy and an abdominal computed tomographic scan were normal. Multiple jejunoileal diverticula, without duodenal diverticula, were detected on x-ray films of the small bowel (arrows); their presence doubled the size of the bowel wall. The patient responded dramatically to oral antibiotics, which are an effective treatment for the bacterial overgrowth syndrome associated with small-intestine diverticula.