As a result of the variety of presentations, complications of jejunal diverticulosis present a diagnostic and therapeutic challenge for the acute care surgeon. [ncbi.nlm.nih.gov]

• Asymptomatic

  Since operation the patient has remained asymptomatic, which suggests that in certain patients, even with many diverticula, surgical exploration and excision of the diverticula may be curative. [ncbi.nlm.nih.gov]

  Most diverticula are asymptomatic and are detected incidentally. Complications include bleeding, perforation, and malabsorption resulting from bacterial overgrowth. Asymptomatic diverticula require no treatment. [merckmanuals.com]

• Anemia

  A case of left-sided paraduodenal hernia and jejunal diverticulosis is described in 75-year-old man who presented with chronic intermittent abdominal pain, weight loss, and anemia. [ncbi.nlm.nih.gov]

  As anemia was not improved by conservative therapy and selective superior mesenteric angiogram revealed a bleeding lesion in the jejunum, emergency operation was performed. [jlc.jst.go.jp]

  The disease is often asymptomatic and must be taken into consideration in cases of unexplained malabsorption, anemia, chronic abdominal pain and discomfort. [mendeley.com]

  Anemia due to iron deficiency and megaloblastic anemia have often been reported and commonly attributed to malabsorpion, steatorreia, and vitaminic deficit [23, 33]. [wjes.biomedcentral.com]

• Chills

  Case Report A 65-year-old male with no previous surgery presented to our Emergency Department with sudden onset of pain in suprapubic region and left lower quadrant associated with high fever and chills. [sages.org]

  The patient had normal bowel movements and denied any fever, chills, nausea, or vomiting. His medical history was significant for end-stage renal disease (ESRD) from his congenital renal hypoplasia. He received kidney transplant 7 years ago. [najms.org]

  He developed high grade fever with chills and coffee brown copious vomiting since last 2 days. On examination he had a toxic look. He was dehydrated, febrile and anaemic with a coated tongue. [casereports.in]

• Camping

  The jejunal mucosa around the diverticulum was tattooed with Spot TM ink (GI Supply, Camp Hill, PA). She was referred for surgery, and exploratory laparotomy confirmed the endoscopic findings and tattoo. [acgcasereports.gi.org]

• High Fever

  Case Report A 65-year-old male with no previous surgery presented to our Emergency Department with sudden onset of pain in suprapubic region and left lower quadrant associated with high fever and chills. [sages.org]

• Abdominal Pain

  A 33-year man repeatedly presented to emergency with abdominal pain which resolved with analgesics until he developed constipation, vomiting, fever and severe abdominal pain. He had to undergo laparotomy which revealed multiple jejunal diverticula. [ncbi.nlm.nih.gov]

• Nausea

  During the 2 years before the current presentation, she had reported having frequent episodic nausea, abdominal distention, and colic followed by violent fecaloid vomiting. [nejm.org]

  We present the association of enterolithiasis and jejunal diverticulosis causing obstruction of the small intestine in a 74-year-old female who was admitted for abdominal cramps, nausea and vomiting. [ncbi.nlm.nih.gov]

  It is most often asymptomatic but presenting symptoms are nonspecific and include abdominal pain, nausea, diarrhea, malabsorption, bleeding, obstruction, and/or perforation. [utmb.influuent.utsystem.edu]

• Abdominal Distension

  Emergency Presentation • Symptoms – – – – – Generally unwell Pain localising to left iliac fossa* Abdominal distension Altered bowel habit e.g. diarrhoea Nausea/Fever • Signs – LIF tenderness – *Beware RIF pain-in right sided diverticulitis and where [slideshare.net]

  Vomiting, abdominal distension, abdominal pain and weight loss characterize the most common presentations of chronic intestinal pseudo-obstruction. [ncbi.nlm.nih.gov]

• Hematochezia

  Figure 1 Case 3: A 62-year-old male on warfarin presented to the emergency department with melena and hematochezia. Neither EGD nor colonoscopy showed an active bleed. [journals.lww.com]

  Diverticular bleeding manifests as painless hematochezia. Because the bleeding vessel is an arteriole, the amount of blood loss is usually moderate to severe. [merckmanuals.com]

  […] computed tomography (CT) angiography, CT enterography, and conventional angiography can also be used to delineate obscure sources of GIB. 1 Case Report A 63-year old woman was referred to our institution from a community hospital with a 3-day history of hematochezia [acgcasereports.gi.org]

  A hemoglobin level is important in patients who report hematochezia. Electrolyte assays may be helpful in the patient who is vomiting or has diarrhea. Assess renal function prior to the administration of most intravenous contrast material. [emedicine.medscape.com]

• Abdominal Fullness

  These findings include a sensation of vague or localized pain, rectal bleeding and abdominal fullness. [ncbi.nlm.nih.gov]

  The disease often presents with non-specific symptoms like intermittent abdominal pain, dyspepsia, bloating or abdominal fullness, constipation, diarrhoea, malnutrition, anemia due to iron deficiency or megaloblastic anemia. [jovs.amegroups.com]

  Vague and chronic, mainly post prandial, epigastric cramping pain, bloating or abdominal fullness is usually referred. [wjes.biomedcentral.com]

Workup of these symptoms included computed tomography, which showed small-bowel dilatation along with a whirl sign and numerous collateral veins, suggestive of a midgut volvulus (see video ). [nejm.org]

See Workup for more detail. Treatment of diverticulitis The management of patients with diverticulitis depends on their presentation severity, presence of complications, and comorbid conditions. [emedicine.medscape.com]

• Colonic Stricture

  […] resection may be needed. • Post-inflammatory strictures may require elective resection of colon. - If no acute inflammation or abscesses present, can perform a primary anastamosis. - Biopsy all colonic strictures to exclude underlying carcinoma. 35. [slideshare.net]

The treatment is mainly surgical; however, there have been cases where nonsurgical management was successful. [ncbi.nlm.nih.gov]

The signs, symptoms, diagnosis, complications and treatment of JD will be discussed through a review of the literature and a series of cases from our own institution. [karger.com]

Prognosis The prognosis is good even with complications. [emedicine.medscape.com]

Course & Prognosis • 10-20% of patients experience complications, mainly diverticulitis and lower GI bleeding. • Conservative management of diverticular disease is preferred. • Surgery reserved for major complications. • In UK, surgery usually for cases [slideshare.net]

Telomere Length in Leukocyte DNA in Gastric Cancer Patients and its Association with Clinicopathological Features and Prognosis. [hospital.fujita-hu.ac.jp]

[…] gas and fluid into pelvis and peritoneal cavity abscess formation (seen in up to 30% of cases) may contain fluid, gas or both fistula formation (usually a chronic complication) gas in the bladder direct visualization of a fistulous tract Treatment and prognosis [radiopaedia.org]

A 78-year-old man with bowel obstruction of unknown etiology was initially managed conservatively, but suffered recurrence of the obstruction. [ncbi.nlm.nih.gov]

Etiology The chief predisposing factors of diverticulosis of the small intestines may be summarized briefly as follows: Article History Published in print: Apr 1946 [pubs.rsna.org]

A literature review has revealed that these signs have been present in other cases of jejunal diverticulosis, although the etiology and pathophysiology is not clearly understood. [paperity.org]

Diverticulose Etiologie Homme Intestin grêle Jéjunum Malabsorption intestinale Polyneuropathie périphérique Système nerveux pathologie Thiamine Keyword (en) Digestive diseases Bacteria Vitamin deficiency Chronic Colonization Complication Diverticulosis Etiology [pascal-francis.inist.fr]

A brief review of the epidemiology, pathogenesis, and clinical presentation displays the variety of symptoms associated with these rare conditions. [ncbi.nlm.nih.gov]

Systemic sclerosis Visceral myopathy Visceral neuropathy Epidemiology United States Duodenal diverticula are approximately five times more common than jejunoileal diverticula. [emedicine.medscape.com]

[citation needed] Epidemiology[edit] The prevalence of diverticulosis progressively increases with age. [en.wikipedia.org]

Colonic diverticulosis and diverticular disease: Epidemiology, risk factors, and pathogenesis. https://www.uptodate.com/contents/search. Accessed July 24, 2018. Tursi A, et al. [mayoclinic.org]

Pathophysiology, Diagnosis, Management, 2nd Ed. Philadelphia, Saunders, 1978, pp 1094–1103 Google Scholar 11. Ament ME, Shimoda SS, Saunders DR, et al: Pathogenesis of steatorrhea in three cases of small intestinal stasis syndrome. [springerlink.com]

A literature review has revealed that these signs have been present in other cases of jejunal diverticulosis, although the etiology and pathophysiology is not clearly understood. [paperity.org]

"Etiology and pathophysiology of diverticular disease". Clinics in Colon and Rectal Surgery. 17 (3): 147–53. doi:10.1055/s-2004-832695. PMC 2780060. [en.wikipedia.org]

Pathophysiology The cause of this condition is not known. It is believed to develop as the result of abnormalities in peristalsis, intestinal dyskinesis, and high segmental intraluminal pressures. [emedicine.medscape.com]

// British Medical Journal;7/26/1980, Vol. 281 Issue 6235, p273 Diarrhoea is occasionally encountered during cimetidine treatment but no satisfactory pathophysiological mechanism has been proposed. [connection.ebscohost.com]

Because jejunal diverticula may be encountered during a sonographic examination, sonologists should be aware of their sonographic appearance to prevent diagnostic errors. [ncbi.nlm.nih.gov]

Because jejunal diverticula may be encountered during a sonographic examination, sonologists should be aware of their sonographic appearance to prevent diagnostic errors. © 2006 Wiley Periodicals, Inc. [onlinelibrary.wiley.com]

Early diagnosis and proper management is important to prevent morbidity. Diagnostic modalities that are helpful include abdominal CT or MRI, capsule endoscopy, and deep enteroscopy. © The American College of Gastroenterology 2016. [journals.lww.com]