Jejunoileal Diverticulosis has Heterogeneous Pathophysiology and Requires Special Consideration During Treatment

Abstract

Jejunoileal diverticulosis (JID) is a rare condition with a reported incidence lower than 0.1%. The clinical presentation of JID varies widely; the incidence of complications requiring surgical intervention is reported as 10%. Surgery is the definitive treatment for JID and can be considered to improve the patient’s quality of life and to prevent further severe symptoms. The first patient was a 77-year-old male with a history of JID that had caused intermittent abdominal pain for the last year. He underwent laparoscopic surgery without segmental resection, however, symptoms recurred and he underwent definitive robotic small bowel resection. Pathology revealed JID with true diverticula. The second patient was a 72-year-old male who presented with rectal bleeding that caused hypotension. Jejunostomy was required initially and definitive open surgery was performed later to resect the bowel segment affected by JID. Pathology showed pseudodiverticular JID. JID patients may present with a pseudodiverticulum or a true diverticulum, with severe or mild symptoms and with perforation or minimal inflammation. Physicians treating this heterogeneous disease need to know the complex underlying mechanisms as well as the multiple management options. We share our experience with two distinct cases and discuss the presentation and management approaches for JID to give an inclusive picture of the disease.

Keywords

• Jejunoileal
• diverticulosis
• robotic surgery