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Non-Meckel Small Intestine Diverticulitis.

Shamim Ejaz1, Raghu Vikram2, John R Stroehlein1

  • 1Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Case Reports in Gastroenterology
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Summary

Non-Meckel small intestine diverticulitis presents with varied symptoms and can be overlooked. Conservative management is effective for elderly patients, avoiding surgical risks.

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DiverticulitisManagementSmall intestine

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Area of Science:

  • Gastroenterology
  • Abdominal Surgery

Background:

  • Non-Meckel small intestine diverticulitis is a rare condition with poorly defined management strategies.
  • It often presents atypically, leading to diagnostic challenges, particularly in elderly patients.

Observation:

  • This report details four cases of non-Meckel small intestine diverticulitis diagnosed between 1999 and 2014 in elderly patients (median age 82).
  • All patients presented with acute abdominal pain, and computed tomography (CT) scans revealed small intestine diverticulitis unrelated to malignancy.
  • Diverticula were primarily located in the duodenum and jejuno-ileal segments, with some cases showing peripancreatic inflammation and localized perforation.

Findings:

  • Despite complications like inflammation and perforation, all patients were successfully treated conservatively.
  • Computed tomography scans proved valuable in identifying the condition, aiding in differential diagnosis for acute abdominal pain.

Implications:

  • Non-Meckel small intestine diverticulitis should be considered in the differential diagnosis of acute abdominal pain, especially in older individuals.
  • Conservative management appears to be a viable and safer alternative to surgery for non-Meckel small intestine diverticulitis, reducing potential morbidity and mortality.