title: Clinical implications of small bowel diverticula.
abstract: BACKGROUND
  Small bowel diverticula are usually asymptomatic and rare. Their importance is based on the fact that they carry the risk of serious complications.
  
  
  OBJECTIVE
  To study the implications and the therapeutic approach regarding small bowel diverticulosis.
  
  
  METHODS
  The medical records of 54 patients with diverticular disease of the small bowel, including Meckel's and duodenum diverticula, were retrospectively reviewed. The mean age of the 32 male and 22 female patients was 53.2 years.
  
  
  RESULTS
  Diverticula were found in the duodenum in 11 cases, in the jejunum and ileum in 21 cases, and with Meckel's diverticula in 22 cases. In 24% of the patients the diverticula were multiple. The most common clinical symptom was abdominal pain, in 44.4%. Most of the duodenum diverticula were asymptomatic; 47.6% of the patients with diverticular disease located in the jejunum and ileum presented with chronic symptoms. The overall diagnostic rate for symptomatic diverticula before surgery was 52.7%; in 33.3% diverticula were found incidentally during other diagnostic or therapeutic procedures. Forty-one patients were managed surgically. 15 patients were operated on urgently because of infection or rupture, 4 patients for bleeding, 5 patients for intestinal obstruction, and one patient for jaundice.
  
  
  CONCLUSIONS
  The incidence of asymptomatic small bowel diverticula is difficult to ascertain. Patients with Meckel's and duodenal diverticula are usually asymptomatic, while the majority of jejunal and ileal diverticula patients present with chronic symptoms. The pre-operative diagnostic rate is higher for duodenal diverticula. Small bowel diverticula do not require surgical treatment unless refractory symptoms or complications occur.
authors.affiliation: Second Department of Gastrointestinal Surgery, University of Athens Medical School, Athens, Greece. gkouraklis@hotmail.com
authors.forename: Gregory
authors.initials: G
authors.lastname: Kouraklis
authors.forename: Andromachi
authors.initials: A
authors.lastname: Glinavou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Mantas
authors.forename: Efstratios
authors.initials: E
authors.lastname: Kouskos
authors.forename: Gabriel
authors.initials: G
authors.lastname: Karatzas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004240:Diverticulum / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies