Small Bowel Diverticulosis in an Elderly Patient Presenting With Obstruction and Intestinal Dysmotility: A Case...

Small bowel diverticulosis can occur anywhere in the small bowel but is most common in the duodenum. Jejunoileal diverticulosis is much less common and tends to have a more chronic, nonspecific disease course. In the literature, this condition has a higher incidence in men in their sixth and seventh decades of life. Diagnosis of small bowel diverticula can be difficult and may depend on surgical exploration of the bowel content to confirm the final diagnosis. An 81-year-old elderly female patient with no past surgical history presented with chronic abdominal pain, distension after eating, occasional diarrhea, and weight loss. Her initial presentation was concerned with pseudo-obstruction and possible internal hernia. She had multiple rounds of antibiotics to diagnose small intestinal bacterial overgrowth (SIBO). After a diagnostic laparoscopy due to persistent symptoms, the diagnosis of small bowel diverticulosis was confirmed. The patient ultimately decided to undergo a laparotomy with a small bowel resection to treat her condition. Her postoperative course was complicated by an episode of Giardiasis, which was treated with a course of antibiotics. Upon her follow-up appointment in the clinic, she reported doing well without any complaints. While small bowel diverticulosis can be asymptomatic, a presentation of persistent symptoms, including generalized abdominal pain, diarrhea, and distension, can occur, especially in the older population of patients. Diagnosing this condition can be challenging and usually can be accomplished through laparoscopy. However, definitive treatment leading to the cessation of symptoms can only be achieved through surgical resection of the involved segment of the bowel.