Journal of Yeungnam Medical Science

Review article

Recent updates on classification and unsolved issues of diverticular disease: a narrative review: Kyeong Ok Kim; Received June 4, 2024 Accepted July 11, 2024 Published online August 30, 2024; DOI: https://doi.org/10.12701/jyms.2024.00542 [Epub ahead of print]

Abstract PDF: Recently, a paradigm shift has occurred in the classification of diverticular disease and the understanding of its pathogenesis. Diverticular disease is now defined as a variety of clinically significant conditions such as diverticulitis, diverticular bleeding, symptomatic uncomplicated diverticular disease, and segmental colitis associated with diverticulosis. Low-grade inflammation, visceral hypersensitivity, abnormal intestinal motility, and genetic factors have emerged as the key contributors to the pathogenesis of diverticular disease. Routine antibiotic use is no longer recommended for all cases of diverticulitis, and simple recurrence is not an indication for surgical treatment. Early colonoscopy with proper preparation is recommended for the treatment of diverticular bleeding, although recent studies have not shown significant efficacy in preventing recurrence. The roles of dietary fiber, nonabsorbable antibiotics, 5-aminosalicylates, and probiotics in the prevention of diverticular disease are controversial and require further investigation.

Case Report

A Case of Jejunal Diverticulitis with Perforation Combined with Intussusception Caused by Inflammatory Fibroid Polyp.: Jae Won Choi, Kook Hyun Kim, Ji Eun Lee, Jun Hwan Kim, Byung Ik Jang, Tae Nyeun Kim, Moon Kwan Chung, Jae Whang Kim; Yeungnam Univ J Med. 2005;22(1):113-118. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.113

Abstract PDF: Diverticulosis of the small intestine is a rare entity, compared with that of duodenum or colon, and is found in only 1% of autopsied patients. The main complications are diverticulitis with or without a perforation, obstruction and hemorrhage, which are associated with a high mortality. Intussusception is primarily a disease of childhood; with only 5 to 10% of cases occurring in adults. In contrast to childhood intussusception, 90% of adult intussusception cases are had an associated pathologic processes. An inflammatory fibroid polyp is an uncommonly localized non-neoplastic lesion of the gastrointestinal tract. It occurs most often in the stomach and secondly in the ileum. It rarely occurs in other organs such as the colon, jejunum, duodenum and esophagus. We report a case of jejunal diverticulitis with a perforation combined with intussusception caused by an inflammatory fibroid polyp. A 78-year-old female presented with abdominal pain, fever and chill. Contrast CT scan showed intussusception of the ileum. The patient was treated with a small bowel segmental resection. After surgery, the specimen showed jejunal diverticulitis with perforation.

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