Acute terminal ileal diverticulitis

Discussion:

Terminal ileum diverticulitis is a rare disease that may lead to an acute abdomen mimicking appendicitis. It is not Meckel diverticulitis nor other true diverticulum rather an acquired condition possibly due to the same causes as colonic diverticular disease i.e. pseudodiverticula.

These diverticula are usually multiple and occur at the mesenteric border, sometimes hidden in the mesentery and overlooked during surgery. Most patients are asymptomatic and diagnosis is made on routine imaging studies or at autopsy. The acute complications of ileal diverticula including inflammation are very rare.

The management of ileal diverticulitis is similar to that of colonic diverticulitis, i.e. treated conservatively if recognized on imaging prior to laparotomy. For those who present with complications such as bleeding, obstruction or perforation, surgical intervention is required.

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