Analysis of clinical manifestations of symptomatic acquired jejunoileal diverticular disease.
OBJECTIVE
To analyze systematically our experience over 22 years with symptomatic acquired diverticular disease of the jejunum and ileum, exploring the clinical manifestations and diagnosis of this rare but life-threatening disease.


METHODS
The medical records of patients with surgically confirmed symptomatic jejunoileal diverticular disease were retrospectively reviewed. Data collected included demographic data, laboratory results, clinical course (acute or chronic), preoperative diagnosis, and operative findings. Inclusion criteria were as follows: (1) surgical confirmation of jejunoileal diverticular disease and (2) exclusion of congenital diverticula (e.g. Meckel's diverticulum).


RESULTS
From January 1982 to July 2004, 28 patients with a total of 29 operations met the study criteria. The male:female ratio was 14:14, and the mean age was 62.6+/-3.5 years. The most common manifestation was abdominal pain. In nearly half of the patients, the symptoms were chronic. Two patients died after surgery. Only four cases were correctly diagnosed prior to surgery, three by small bowel series.


CONCLUSIONS
Symptomatic acquired small bowel diverticular disease is difficult to diagnose. It should be considered in older patients with unexplained chronic abdominal symptoms. A small bowel series may be helpful in diagnosing this potentially life-threatening disease.
Liu
Chia-Yuan
CY
Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Section 2, Chung-San North Road, Taipei, Taiwan, China.
Chang
Wen-Hsiung
WH
Lin
Shee-Chan
SC
Chu
Cheng-Hsin
CH
Wang
Tsang-En
TE
Shih
Shou-Chuan
SC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004240:Diverticulum / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis*; D007579:Jejunal Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies