Imaging Approach to Diverticular Disease of the Small Bowel

Acquired diverticular disease of the small bowel is often seen in the duodenum. It is an uncommon but under-recognized entity in the jejunum and the ileum. Meckel's diverticulum, a true diverticulum arising in the distal ileum, although the most common congenital abnormality of the gastrointestinal tract, is rare and occurs in about 2% of the population. Most of the time, diverticular disease of the small bowel is asymptomatic. Common complications of small bowel diverticular disease include diverticulitis and hemorrhage. Diverticulitis of the small bowel is an uncommon cause of acute abdomen and may be misdiagnosed if not included in differential considerations based on the imaging features. Certain specific complications can occur related to the location of the diverticulum or due to other factors associated with the diverticulum. For example, obstructive jaundice (Lemmel syndrome) can occur in the setting of a duodenal diverticulum, and intestinal obstruction can occur in the setting of a Meckel's diverticulum. Familiarity with the different imaging manifestations of small bowel diverticular disease complications can help with appropriate diagnoses, thereby improving patient management.