IS Case 113: Small Bowel Diverticulosis
Imaging Sciences URMC 2008
Publication Date: 2009-05-20
A 49-year-old male presented with a history of gastrointestinal bleeding.
Small bowel diverticulosis
Small bowel diverticulosis is usually found incidentally during imaging. Diverticula can occur anywhere along the small bowel, but most frequently affects the duodenum. The diverticula generally arise on the mesenteric border of the bowel where the mesenteric vessel insertion produces an effective weak spot in the bowel musculature. Clinical symptoms are rare, but when they do occur, they are usually a result of bacterial overgrowth due to stasis within the diverticula. Fat malabsorption may occur due to bile acid deconjugation. B12 deficiency and resultant macrocytic anemia may also occur. Rarely, this condition may present acutely with intestinal bleeding, as seen in this case. Other rarer presentations include diverticulitis, perforation, volvulus, or obstruction.
Because this is an asymptomatic condition, the exact incidence of small bowel diverticulosis is difficult to ascertain, however, it is estimated at approximately 0.3-2.5%. There is a slight male predilection and the average age of presentation is between 50-70 years old. Duodenal diverticula are associated with biliary stones, pancreatitis and biliary abnormalities. Jejunal/ileal diverticula are associated with motility disorders, such as scleroderma and visceral neuropathies.
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