Author(s): Tsiotos GG, Farnell MB, Ilstrup DM
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Abstract BACKGROUND: Incidentally found asymptomatic disease, chronic pain or malabsorption, emergent disease with complications are the three distinct modes of presentation of nonmeckelian jejunal or ileal diverticulosis (JID). We analyzed our experience with each of these three subsets of cases to determine both the role of operative intervention and an overall management strategy. METHODS: Retrospective analysis was done of 112 clinically diagnosed cases of nonmeckelian JID between 1975 and 1990. RESULTS: JID was an incidental finding in 47 patients (42\%), and 82\% of those who were followed up for a mean of 4.8 years remained asymptomatic. Forty-five patients (40\%) had malabsorption or chronic pain, and only 46\% of those who were followed up for a mean of 6.5 years were cured with conservative therapy. Of the 20 patients (18\%) who had acute complications, 11 (10\%) required operation, which was associated with minimal morbidity and one death. Ninety percent remained asymptomatic for a mean of 3.9 years. CONCLUSIONS: Incidentally found JID is usually asymptomatic and should be observed. Resection for complicated JID is safe and effective. Although malabsorption or chronic pain should be treated medically initially, the significant incidence of failure warrants further study of the role of resection in this group.
This article was published in Surgery
and referenced in Journal of Colitis & Diverticulitis