Jejunal Diverticulosis

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During routine exploration of the abdominal viscera before rectal carcinoma resection, diverticula were found in the jejunum of a 75-year-old woman. These outpouchings were located on the mesenteric side of the bowel. Because the patient was asymptomatic, no treatment was given. The rectal cancer was resected; her postoperative course was uneventful.

Diverticula occur infrequently in the small bowel. They are detected in 0.1% to 0.5% of small-bowel barium studies.

There are 2 types of diverticula of the small intestine: congenital and acquired. Congenital diverticula are situated on the antimesenteric margin of the bowel and are true diverticula—they consist of all layers of the intestinal wall. The acquired diverticula occur on the mesenteric margin of the bowel, where the blood vessels enter the bowel wall. These hernias of the mucous membrane penetrate through the muscle wall at the entrance of the vessels. They are often multiple and thin-walled, as in this patient.

Rarely, jejunal diverticula may be a significant source of GI bleeding. Perforation of these diverticula is highly uncommon. A massive diverticulosis of the small bowel may interfere with the absorptive function of the bowel and may cause malabsorption and steatorrhea.

For patients with symptoms, treatment involves resection of a portion of the small bowel.