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Diverticular disease of small intestine

Last edited: 4/23/2026

Overview

Diverticular disease of the small intestine involves abnormal outpouchings or sacs that form in the intestinal wall, distinct from the more common colonic diverticulosis. These lesions can lead to complications such as bleeding, obstruction, and perforation, necessitating careful clinical evaluation and management 1.

Diagnosis

  • Radiographic Evaluation: Assess small bowel contour and caliber abnormalities using imaging techniques like CT enterography or small bowel follow-through.
  • Clinical Correlation: Integrate radiographic findings with clinical symptoms (e.g., abdominal pain, bleeding) to narrow down diagnosis.
  • Endoscopy: Consider for direct visualization and biopsy when indicated, especially in cases of suspected bleeding or inflammatory changes 1.

    • Management

  • Surgical Intervention: Primary for complications such as bowel obstruction, perforation, or severe bleeding 1.
  • Medical Management: For uncomplicated cases, focus on supportive care including fluid resuscitation, nutritional support, and management of symptoms.
  • Antimicrobial Therapy: Not routinely recommended unless there is evidence of infection or abscess formation 1.

    • Special Populations

  • Elderly: Increased risk of complications; close monitoring and prompt surgical intervention advised for severe cases 1.
  • Comorbidities: Presence of other gastrointestinal diseases may complicate diagnosis and management; tailored approach based on individual patient factors is essential 1.

    • Key Recommendations

  • Utilize radiographic analysis focusing on small bowel contour and caliber abnormalities for initial diagnosis (Evidence: Moderate 1).
  • Integrate clinical symptoms with imaging findings to refine diagnosis of small intestinal diverticulosis (Evidence: Moderate 1).
  • Prioritize surgical intervention for complications such as obstruction, perforation, or significant bleeding (Evidence: Expert opinion 1).

    • References

    1 Goldberg HI, Sheft DJ. Abnormalities in small intestine contour and caliber: a working classification. Radiologic clinics of North America 1976. link

    Original source

    1. [1]
      Abnormalities in small intestine contour and caliber: a working classification. — Goldberg HI, Sheft DJ Radiologic clinics of North America (1976)
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