The jejunum is a more common site of acquired diverticula of the small bowel than the ileum 1.
Diverticulosis of the jejunum and ileum are generally asymptomatic.
If these diverticula become acute inflamed, or even perforate or bleed, then symptoms usually manifest. Indeed, terminal ileal diverticulitis is a rare mimic of acute appendicitis.
The features of jejunoileal diverticulitis are similar to those seen with inflamed diverticula of the large bowel.
- inflamed jejunal/ileal diverticulum
- thickened and enhancing diverticular wall
- peridiverticular mesenteric fat stranding
- acute inflamed adjacent small bowel
- thickened and enhancing bowel wall
- mesenteric fat stranding
- reactive local nodal enlargement
- non-inflamed diverticula of the small bowel elsewhere
Treatment and prognosis
Due to the rarity of the diagnosis, an optimal therapeutic strategy is not known. In one large study of 346 patients with right-sided diverticulitis, only 9 of these were acute ileal diverticulitis, and these were all successfully managed conservatively. No recurrence was reported 2.
- 1. Jeong J, Hong SS, Hwang J, Kim HJ, Chang YW. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings. (2015) Ultrasonography (Seoul, Korea). 34 (1): 74-7. doi:10.14366/usg.14041 - Pubmed
- 2. Park HC, Lee BH. The management of terminal ileum diverticulitis. (2009) The American surgeon. 75 (12): 1199-202. Pubmed
- 3. Graña L, Pedraja I, Mendez R, Rodríguez R. Jejuno-ileal diverticulitis with localized perforation: CT and US findings. (2009) European journal of radiology. 71 (2): 318-23. doi:10.1016/j.ejrad.2008.04.023 - Pubmed