small intestine diverticulitis

Diverticulosis of the small intestine, also known as Meckel’s diverticulum, is a condition where small pouches or sacs (diverticula) develop in the wall of the small intestine. These pouches can become inflamed or infected, leading to diverticulitis.

Symptoms

• Non-specific epigastric pain and bloating sensation [4]
• Abdominal pain that worsens over time [15]

Causes

• Repeated and uneven pressure on the intestinal lining due to constipation or other factors [13]
• Small holes in the diverticulum allowing bacteria from the intestines to be released [14]

Complications

• Fistula formation between the small intestine and other organs, such as the bladder or vagina [10]
• Bowel obstruction: blockage of the large intestine preventing food and stool from passing through [3]

Treatment

• Predominantly surgical treatment for diverticulitis [9]
• Treatment may vary depending on the severity and location of the condition

It's worth noting that small bowel diverticula can occur anywhere in the small bowel, but are most often found in the duodenum. According to a retrospective review of 208 cases, small bowel diverticula were most commonly located in the duodenum [5].

Common Signs and Symptoms

Small intestine diverticulitis can manifest in various ways, but some common signs and symptoms include:

• Abdominal pain: This is often the most prominent symptom, which can range from mild to severe. The pain may be constant or come and go, and it can be felt on one side of the abdomen or all over.
• Bloating and cramping: People with small intestine diverticulitis may experience bloating and cramping in the lower part of the belly, especially after eating.
• Nausea and vomiting: Some individuals may feel queasy or vomit due to the discomfort caused by the condition.
• Fever and chills: In some cases, a high fever and chills can occur, indicating an infection.

Complications

If left untreated, small intestine diverticulitis can lead to more serious complications, such as:

• Bleeding: Diverticula in the small intestine can bleed, leading to blood in the stool or black tarry stools.
• Perforation: A perforated bowel is a medical emergency that requires immediate attention. Peritonitis (infection of the lining surrounding the intestines) can occur if the diverticulum perforates.
• Bowel obstruction: Over time, inflammation from small intestine diverticulitis can lead to a bowel obstruction, causing constipation, thin stools, diarrhea, bloating, and belly pain.

Mild Cases

In some cases, people with small intestine diverticulosis may not experience any symptoms at all. However, when symptoms do occur, they are often mild and may include:

• Bloating: Some individuals may notice bloating or gas in the lower part of the abdomen.
• Cramping: Mild cramping can also be a symptom.

References

• [1] Oct 22, 2024 — This common colon disease develops when small pouches form in the colon wall and become inflamed, causing pain, fever and abnormal stool ...
• [3] by FE Ferreira-Aparicio · 2012 · Cited by 69 — The most common symptom is non-specific epigastric pain and a bloating sensation. Major complications include diverticulitis, gastrointestinal ...
• [5] Feb 1, 2016 — Complications of diverticula include bleeding, perforation, and diarrhea with malabsorption resulting from bacterial overgrowth.
• [9] Aug 28, 2023 — Over time, the inflammation can lead to a bowel obstruction, which may cause constipation, thin stools, diarrhea, bloating, and belly pain.

To diagnose small intestine diverticulitis, several diagnostic tests can be used. Here are some of them:

• Blood tests: A healthcare professional may order blood tests to check for signs of infection or inflammation in the body. This can include a full blood count (FBC) to check for an elevated white blood cell count, which can indicate an infection [3].
• Imaging tests: Imaging tests such as CT scans, ultrasound, and MRI can be used to visualize the small intestine and detect any abnormalities, including diverticula and inflammation. A CT scan is often the preferred imaging modality for diagnosing acute diverticulitis and complicated diverticular disease [14].
• Stool test: A stool test may be ordered to check for signs of infection or gastrointestinal bleeding.
• Colonoscopy: While primarily used to diagnose colon conditions, a colonoscopy can also be used to visualize the small intestine and detect any abnormalities.

It's worth noting that the diagnosis of small intestine diverticulitis can be challenging, and a combination of these tests may be necessary to confirm the diagnosis. A healthcare professional will use their clinical judgment to determine which tests are necessary based on individual patient factors [13].

References: [3] - Elevated white blood cell count may occur in diverticulitis. [14] - Computed tomography scan is the imaging modality of choice for acute diverticulitis and complicated diverticular disease.

Based on the provided context, it appears that drug treatment for small intestine diverticulitis may involve antibiotics and hydration.

• According to search result [8], conservative management of small intestine diverticulitis may include treatment with parenteral antibiotics and hydration, which worked well.
• Search result [3] mentions IV fluid and broad-spectrum antibiotic coverage as part of the medical management for diverticulitis, although it does not specifically mention small intestine diverticulitis.

It's worth noting that the severity and specific characteristics of the condition may influence the treatment approach. However, based on the available information, antibiotics and hydration seem to be a potential part of the drug treatment for small intestine diverticulitis.

References: [3] - Treatment options mentioned: Bed rest, Nothing by mouth and/or nasogastric suctioning, IV fluid, Broad-spectrum antibiotic coverage [8] - Conservative management of small intestine diverticulitis includes parenteral antibiotics and hydration

The differential diagnosis of small intestine diverticulitis includes several conditions that can present with similar symptoms. According to the provided context, some of these conditions are:

• Perforated neoplasm [3]
• Foreign body perforation [7]
• Small-bowel ulceration from nonsteroidal anti-inflammatory drug use [3]
• Crohn's disease [3]
• Acute pancreatitis [2]
• Chronic pancreatitis [2]
• Upper gastrointestinal bleeding (UGIB) [2]
• Small-Bowel Obstruction [2]

It is essential to consider these conditions in the differential diagnosis of small intestine diverticulitis, as they can all present with symptoms such as abdominal pain and inflammation.

Additionally, according to context [6], small bowel diverticulitis other than non-Meckel can present as acute abdominal pain and should always be considered in the differential diagnosis. Context [7] also mentions that the differential diagnosis of jejunoileal diverticulitis includes secondary inflammation from adjacent structure, perforated neoplasm, foreign body perforation, and other conditions.

It's worth noting that small intestine diverticulitis is a relatively rare condition compared to colonic diverticulosis, with an estimated incidence of 1-4% [14]. However, it can still present a significant diagnostic challenge due to its similarity in presentation to other gastrointestinal conditions.