Acute Ileo-jejunal Diverticulitis: a 10-Year Single-center Experience

Abstract

Acute ileo-jejunal diverticulitis (AIJD) is a very uncommon entity with an unknown real prevalence. It usually presents non-specific symptomatology. There is no consensus on the optimal treatment due to the scarcity of studies on the subject. This study aimed to assess the clinical manifestations and short-term outcomes after conservative or surgical treatment for AIJD. A retrospective analytical study was conducted. A search for all patients diagnosed with AIJD in the period between 2009 and 2019 was performed in our center. Demographic, clinical, laboratory, and radiological data were collected. This study aimed to assess the differences between patients who received surgical treatment and those who received conservative treatment. We identified 24 patients with acute ileo-jejunal diverticulitis. A lower rate of surgical treatment was observed in patients with a higher age-adjusted Charlson comorbidity index (p = 0.038). There were no statistically significant differences in the demographic, clinical, laboratory, and radiological data according to conservative or invasive management, except in patients in whom an enterolith was identified in computed tomography. All those patients underwent surgical treatment (p = 0.027). A higher rate of conservative treatment failure was found at higher stages (Ib, II, and III) of the modified Hinchey classification. Mortality within 30 days of surgery was 12%. AIJD is an uncommon entity with significant mortality rates. In the presence of enteroliths, peri-intestinal or pelvic abscess, and generalized peritonitis, surgical treatment was mandatory. Conservative treatment may be an option in non-severe cases.