Diverticulitis of the small bowel: CT diagnosis

In contrast with their colonic equivalents, noncolonic diverticula of the gastro-intestinal tract are much rarer and an uncommon site of inflammation. Symptoms and signs are generally nonspecific and before the advent and development of CT, clinical and radiological diagnosis was very difficult. As a result laparotomy was carried out in most cases without correct preoperative diagnosis. We report three rare cases of noncolonic diverticulitis, respectively, affecting the duodenum, the jejunum, and the distal ileum. MDCT with multiplanar reconstructions revealed unambiguously diagnostic features in the three cases and allowed minimally invasive endoscopic drainage in the duodenal case and successful conservative medical treatment in the jejunal and ileal cases. We discuss and review the prevalence, physiopathology, symptoms, and complications of diverticula of the duodenum and jejuno-ileum and emphasis on the high performance of MDCT for the diagnosis of acute diverticular complications.