Jejunoileal diverticula as a rare cause of acute abdomen

The diverticula of the small bowel may be congenital or acquired. The congenital form is Meckel's diverticulum, which is a true diverticulum formed by the complete bowel wall and located on the antimesenteric border of the distal ileum. Acquired jejunoileal diverticula develop during an individual's lifetime. Small bowel motility disorders with increased intraluminal pressure are considered to be the main aetiological factor for their development. They may be composed of mucosa and submucosa only (referred to as false diverticula) or, all layers of the small bowel wall. To differentiate them from Meckel's diverticulum, they are often multiple and located on the mesenteric side of the bowel. In exclusion of the stomach, jejunoileal diverticula represent the rarest form of gastrointestinal diverticular disease. Most of them are asymptomatic, but can also be present with chronic symptomatology or, life-threatening complications, i.e. inflammation with subsequent perforation, massive bleeding, obstruction and/or malabsorption. The diagnosis of symptomatic or complicated small bowel diverticulosis is often difficult and delayed, resulting in unnecessary morbidity and mortality. Three case reports are presented below. The clinical significance, diagnostic and therapeutic management are discussed herewith.