Imaging of Small Bowel

Chapter
First Online:

Abstract

Small bowel diverticulitis is most commonly characterized by inflammation of acquired diverticula which are typically located on the mesenteric border of the bowel. Although less frequent than duodenal diverticula, jejunoileal diverticula are more prone to develop complications, including acute inflammation with perforation and abscess formation. The current mode of treatment for small bowel diverticulitis is either with conservative medical management or surgical resection of the involved segment of bowel.

Keywords

Small bowel diverticulitis Meckel’s diverticulitis Acute mesenteric ischemia Pneumatosis intestinalis Bowel perforation 
This is a preview of subscription content, log in to check access.

References

  1. 1.
    Akhrass R, Yaffe MB, Fischer C, Ponsky J, Shuck JM. Small-bowel diverticulosis: perceptions and reality. J Am Coll Surg. 1997;184(4):383–8.PubMedGoogle Scholar
  2. 2.
    Coulier B, Maldague P, Bourgeois A, Broze B. Diverticulitis of the small bowel: CT diagnosis. Abdom Imaging. 2007;32(2):228–33.CrossRefPubMedGoogle Scholar
  3. 3.
    Macari M, Faust M, Liang H, Pachter HL. CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management. Clin Radiol. 2007;62(1):73–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Lempinen M, Salmela K, Kemppainen E. Jejunal diverticulosis: a potentially dangerous entity. Scand J Gastroenterol. 2004;39(9):905–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Afridi SA, Fichtenbaum CJ, Taubin H. Review of duodenal diverticula. Am J Gastroenterol. 1991;86(8):935–8.PubMedGoogle Scholar
  6. 6.
    Yin WY, Chen HT, Huang SM, Lin HH, Chang TM. Clinical analysis and literature review of massive duodenal diverticular bleeding. World J Surg. 2001;25(7):848–55.CrossRefPubMedGoogle Scholar
  7. 7.
    Maglinte DD, Chernish SM, DeWeese R, Kelvin FM, Brunelle RL. Acquired jejunoileal diverticular disease: subject review. Radiology. 1986;158(3):577–80.CrossRefPubMedGoogle Scholar
  8. 8.
    Chendrasekhar A, Timberlake GA. Perforated jejunal diverticula: an analysis of reported cases. Am Surg. 1995;61(11):984–8.PubMedGoogle Scholar
  9. 9.
    Gotian A, Katz S. Jejunal diverticulitis with localized perforation and intramesenteric abscess. Am J Gastroenterol. 1998;93(7):1173–5.CrossRefPubMedGoogle Scholar
  10. 10.
    Krishnamurthy S, Kelly MM, Rohrmann CA, Schuffler MD. Jejunal diverticulosis. A heterogenous disorder caused by a variety of abnormalities of smooth muscle or myenteric plexus. Gastroenterology. 1983;85(3):538–47.PubMedGoogle Scholar
  11. 11.
    Vijayaraghavan SB, Krishnaraj B, Sarveswaran V. Sonographic features of mesenteric gas. J Ultrasound Med. 2004;23(11):1507–10.CrossRefPubMedGoogle Scholar
  12. 12.
    Peters R, Grust A, Gerharz CD, Dumon C, Furst G. Perforated jejunal diverticulitis as a rare cause of acute abdomen. Eur Radiol. 1999;9(7):1426–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Tsiotos GG, Farnell MB, Ilstrup DM. Nonmeckelian jejunal or ileal diverticulosis: an analysis of 112 cases. Surgery. 1994;116(4):726–31.PubMedGoogle Scholar
  14. 14.
    Pearl MS, Hill MC, Zeman RK. CT findings in duodenal diverticulitis. AJR Am J Roentgenol. 2006;187(4):W392–5.CrossRefPubMedGoogle Scholar
  15. 15.
    Koger KE, Shatney CH, Dirbas FM, McClenathan JH. Perforated jejunal diverticula. Am Surg. 1996;62(1):26–9.PubMedGoogle Scholar
  16. 16.
    Williams RA, Davidson DD, Serota AI, Wilson SE. Surgical problems of diverticula of the small intestine. Surg Gynecol Obstet. 1981;152(5):621–6.PubMedGoogle Scholar
  17. 17.
    Kubota T. Perforated jejunal diverticulitis. Am J Surg. 2007;193(4):486–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Novak JS, Tobias J, Barkin JS. Nonsurgical management of acute jejunal diverticulitis: a review. Am J Gastroenterol. 1997;92(10):1929–31.PubMedGoogle Scholar
  19. 19.
    Prakash C, Clouse RE. Acute ileal diverticulitis. Am J Gastroenterol. 1998;93(3):452–4.CrossRefPubMedGoogle Scholar
  20. 20.
    Franzen D, Gurtler T, Metzger U. Multiple recurrent perforated jejunal diverticulitis. Chirurg. 2002;73(12):1218–20.CrossRefPubMedGoogle Scholar
  21. 21.
    Singh A, Raman S, Brooks C, Philips D, Desai R, Kandarpa K. Giant colonic diverticulum: percutaneous CT-guided treatment. J Comput Assist Tomogr. 2008;32(2):204–6.CrossRefPubMedGoogle Scholar
  22. 22.
    Elsayes KM, Menias C, Harvin HJ, Francis IR. Imaging manifestations of Meckel’s diverticulum. AJR Am J Roentgenol. 2007;189:81–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Levy AD, Hobbs CM. Meckel diverticulum: radiologic features with pathologic correlation. Radiographics. 2004;24:565–87.CrossRefPubMedGoogle Scholar
  24. 24.
    Wilcox RD, Shatney CH. Surgical implications of jejunal diverticula. South Med J. 1988;81(11):1386–91.CrossRefPubMedGoogle Scholar
  25. 25.
    Cross MJ, Snyder SK. Laparoscopic-directed small bowel resection for jejunal diverticulitis with perforation. J Laparoendosc Surg. 1993;3(1):47–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Trompeter M, Brazda T, Remy CT, Vestring T, Reimer P. Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy. Eur Radiol. 2002;12:1179–87.CrossRefPubMedGoogle Scholar
  27. 27.
    Menke J. Diagnostic accuracy of multidetector CT in acute mesenteric ischemia: systematic review and meta-analysis. Radiology. 2010;256(1):93–101.CrossRefPubMedGoogle Scholar
  28. 28.
    Kirkpatrick ID, Kroeker MA, Greenberg HM. Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: initial experience. Radiology. 2003;229(1):91–8.CrossRefPubMedGoogle Scholar
  29. 29.
    Lassandro F, di Santo Stefano MLM, Maria Porto A, Grassi R, Rotondo A, Scaglione M. Intestinal pneumatosis in adults: diagnostic and prognostic value. Emerg Radiol. 2010;17:361–5.CrossRefPubMedGoogle Scholar
  30. 30.
    Felson B, Wiot JF. Another look at pneumoperitoneum. Semin Roentgenol. 1973;8:437–43.CrossRefPubMedGoogle Scholar
  31. 31.
    Menuck L, Siemens PT. Pneumoperitoneum: importance of right upper quadrant features. AJR Am J Roentgenol. 1976;127:753–6.CrossRefPubMedGoogle Scholar
  32. 32.
    Levine MS, Scheiner JD, Rubesin SE, Laufer I, Herlinger H. Diagnosis of pneumoperitoneum on supine abdominal radiographs. AJR Am J Roentgenol. 1991;156:731–5.CrossRefPubMedGoogle Scholar
  33. 33.
    Cho KC, Baker SR. Air in the fissure for the ligamentum teres: new sign of intraperitoneal air on plain radiographs. Radiology. 1991;178:489–92.CrossRefPubMedGoogle Scholar
  34. 34.
    Orchard JL, Petorak V. Abnormal abdominal CT findings in a patient with giardiasis. Resolution after treatment. Dig Dis Sci. 1995;40:346–8.CrossRefPubMedGoogle Scholar
  35. 35.
    Puylaert JBCM, Van der Zant FM, Mutsaers JA. Infectious ileocecitis caused by Yersinia, Campylobacter, and Salmonella: clinical, radiological and US findings. Eur Radiol. 1997;7:3–9.CrossRefPubMedGoogle Scholar
  36. 36.
    Antonopoulos P, Constantinidis F, Charalampopoulos G, Dalamarinis K, Karanicas I, Kokkini G. An emergency diagnostic dilemma: a case of Yersinia enterocolitica colitis mimicking acute appendicitis in a beta-thalassemia major patient: the role of CT and literature review. Emerg Radiol. 2008;15:123–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Puylaert JBCM, Lalisang RI, van der Werf SDJ, Doornbos L. Campylobacter ileocolitis mimicking acute appendicitis: differentiation of graded-compression ultrasound. Radiology. 1988;166:737–40.CrossRefPubMedGoogle Scholar
  38. 38.
    Horton KM, Corl FM, Fishman EK. CT of nonneoplastic diseases of the small bowel: spectrum of disease. J Comput Assist Tomogr. 1999;23:417–28.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Ajay Singh
    • 1
    • 2
  • Mohammad Mansouri
    • 3
  • Terry S. Desser
    • 4
  1. 1.Division of Emergency Radiology, Department of RadiologyMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical School, Massachusetts General HospitalBostonUSA
  3. 3.Department of RadiologyMassachusetts General HospitalBostonUSA
  4. 4.Department of RadiologyStanford University School of MedicineStanfordUSA

Personalised recommendations