Table 2 .

1

C1: 36/F

C2: 75/F

C 1: Abd pain, N&V

C 2: Abd pain, N&V and fever

AXR, Abd CT

C 1: AXR: air under the diaphragm, Abd CT: free air, fluid collection, and edema in the mesentery

C 2: AXR: N, Abd CT: no free air, no fluid collection, edema in the small bowel loops

C1: Laparotomy: segmentary small bowel resection, side-by-side anastomosis

C 2: Laparotomy: segmentary small bowel resection, side-by-side anastomosis

2

90/ F

Abd pain

Abd CT

Perforated jejunal diverticulum with abscess formation

Laparotomy

3

Group I (106 pts):the mean age was 72.2 ± 13.1 y/F,M

Group II (113pts): the mean age was 67.6 ± 16.4 y/F,M

Group III (47 pts): the mean age was 65.4 ± 14.4 y/F,M

Group I: moderate fever (46.9%), no fever (26.5%), high fever in 26.5%

AXR, Abd CT, and exp laparotomy

Group I: 92 pts underwent surgery: small bowel resection (83, 90.1%), followed by suture closure (5, 5.5%). Two patients (2.2%) underwent complex procedures that included multiple resections and 2 (2.2%) underwent surgical exploration with drainage

Group II: laparotomy: small bowel resection in 93 (82.3%) patients and enterorrhaphy in 17 (15%)

Group II: 46 pts underwent surgery: Small bowel resection was performed in 31 (67.4%) pts and suture closure in 15 (32.6%)

Group I: 14 pts were treated conservatively

Group II: only one pt was treated conservatively

4

Range 59–83 /F,M

Abd pain

Abd CT, Exp laparotomy

pt1: extensive jejunal diverticulosis, adjacent mesenteric abscess, pt2: single jejunal diverticula with an adjacent mesenteric abscess, pt3: free air in the abdomen, faecal peritonitis and multiple jejunal diverticula, pt 4: Occlusion, solid tumour, pt5: faecal peritonitis and diverticula perforation, pt6: multiple jejunal diverticula and an abscess, pt7: occlusion, pt8: multiple jejunal diverticulosis and a jejuno-colic fistula

Laparotomy: Resection of the involved jejunal segment with primary anastomosis was performed in 6 of the 7 patients with acute symptoms. In patient 7 laparotomy with decompression only was performed because of adhesiolysis. Pt 8: Nefrectomy. Excision of fistula and end to end anastomosis

5

Middle aged/ M

Abd pain

AXR, Abd CT

AXR: N

Abd CT: a large calcified mass within the lumen of the small bowel, with evidence of mesenteric twist or volvulus

Laparotomy: segmentary small bowel resection, side-by-side anastomosis

6

C1: 74 /M

C2: 65 /F

C1: Abd pain and vomiting

C2: Abd pain, vomiting, and anorexia

C1: AXR

C2: AXR and laparoscopy

C1: AXR: N

C2: AXR: dilated small bowel loops in upper abdomen, Diagnostic laparoscopy: multiple interloop adhesions

C2: Laparotomy: Laparoscopic adhesiolysis with resection of involved segment and jejuno-jejunal anastomosis

C1: Conservatively

7

59 /F

Abd pain

Abd CT

Jejunal loop with a large diverticulum on the mesenteric side with diverticulitis and perforation

Laparotomy: segmentary small bowel resection, side-by-side anastomosis

4 other large non-inflamed diverticula are not excised, as this would have required multiple further small bowel resections and anastomoses with associated increased morbidity

8

50 /M

Abd pain and nausea

AXR, Exp laparotomy

AXR: multiple air fluid levels

At surgery: multiple jejunal diverticula with a perforation in one of the diverticulum

Laparotomy: segmentary small bowel resection, side-by-side anastomosis

9

82 /M

Abd pain and nausea

Abd CT

A hollow viscus perforation with intra-abd free air and intra-pelvic free fluid

Laparotomy: segmentary small bowel resection, side-by-side anastomosis

10

80/F

Abd pain and vomiting

Abd CT

fluid and gas surrounding the second and third portions of the duodenum, thickening of the duodenal wall, retroperitoneal fat stranding and perihepatic free fluid

Laparotomy: diverticulectomy with single-layer closure was performed

11

74 /F

Abd pain, N&V

CXR, AXR

free gas under the right hemidiaphragm and nonspecific gaseous distension of the small bowel

Laparotomy: Resection of the involved jejunal segment and a primary jejunal anastomosis were performed

12

63/M

Abd pain

AXR, Abd CT

AXR: non-specific gaseous distension of the large and small bowel

Abd CT: an area of apparent communication between right-sided loops of small bowel with visualised extraluminal gas, a calcific focus noted central to the involved segment

Exploratory laparotomy: segmentary small bowel resection, side-by-side anastomosis (On presumption of perforation)

13

56 /M

Abd pain

AXR, Abd CT

AXR: air under the diaphragm

Abd CT: multiple diverticula in the small intestine and air under the diaphragm suggesting perforation

Laparotomy (Radiological investigations suggested perforation)

14

70 /M

Abd pain

AXR, Exp laparotomy

AXR: air-fluid levels with several dilated loops in the small bowel, but no free peritoneal air

Exploratory laparotomy: multiple diverticulosis with a large inflammatory reaction covering a perforated diverticulum

Exploratory Laparotomy (bowel infarction, perforation, necrosis, ischemia and uncontrolled severe abdominal pain)

15

74 /F

Abd pain, N&V

AXR, Abd CT

AXR two gas fluid lesions in the small intestine

Abdominal CT: multiple diverticula on the mesenteric wall of the small intestine and dilated intestinal loops proximal to the diverticula, but no free air or fluid

Exploratory laparotomy (acute symptoms)

16

82 /F

Abd pain and vomiting

AXR, Abd CT

AXR: multiple dilated loops of small bowel

Abd CT: multiple small bowel diverticula were identified with surrounding pockets of free air adjacent to the jejunal diverticula suggestive of a small bowel perforation

Laparotomy (Abd CT suggested perforation)

17

80/F

Abd pain

AXR, US, Abd CT

AXR: dilated small bowel loops

US: two hypoechoic irregular formations

Abd CT: thickening of the jejunal wall, air bubbles and localized perforation

Conservatively (antibiotic therapy)

18

50/M

Abd pain and nausea

AXR and exp laparotomy

AXR: no free gas under diaphragm and multiple air fluid levels

Exploratory laparotomy (signs of peritonitis, AXR)

19

74/M

Abd pain, constipation, anorexia and fever

CXR, AXR, Exp laparotomy

CXR: N

AXR: prominent but non-dilated small bowel loops

Emergency laparotomy (acute symptoms)

20

76/F

Abd pain and confusion

AXR, Abd CT, Exp laparotomy

AXR: N

Abd CT: a ring enhancing collection, air-fluid level, extensive adjacent mesenteric inflammation, thickened and edematous mid-jejunum loop, intraperitoneal free air, perforated jejunal diverticulitis, abscess, no bowel obstruction/ascites

Laparotomy (Abd CT findings suggested the perforation)

21

74/M

Abd pain and distention, fever

CXR, AXR, Exp laparotomy

CXR, AXR: N Abd CT: extraluminal air, abscess adherent to jejunum

Laparotomy: (Partial enterectomy of 45 cm jejunum including the diverticula and side-to-side anastomosis)

22

63/F

Non-specific abd pain

AXR, CXR, Abd CT

AXR, CXR: N

Abd CT: jejunal diverticulitis surrounded with inflammatory infiltrate and small jejunal diverticula

Conservatively (due to the patient’s comorbidities)

23

79/F

Abd pain, fever, chills

CXR, Abd CT

CXR: N

Abd CT: extraluminal air

Laparotomy: (resection of involved jejunum and end-to-end anastomosis)

24

85/M

Abd pain, hypotension, peritonitis signs

Exp laparotomy

Exp laparotomy: peritoneal contamination, colonic pseudodiverticula, perforated jejunal pseudodiverticulum

Laparotomy (resection of involved jejunum and end-to-end anastomosis)

26

90/M

Abd pain, N&V and diarrhea

Abdominal CT, Exp laparotomy

Abd CT: inflammation, pneumoperitoneum

Laparotomy: small bowel resection with hand-sewn anastomosis

27

pt1: 87/M

pt2: 86/F

pt3: 78/F

pt4: 76/M

pt1: Abd pain and fever

pt2: Abd pain

pt3: Abd pain and diarrhea

pt4: Abd pain and constipation

AXR: pt1, pt4

Abd CT: pt1-4

Endoscopy: pt2

AXR: pt1 N

pt4: prominent small intestine loops, air-fluid levels

Endoscopy: pt2: 2 large diverticula

Abd CT: pt1: multiple diverticula, circumferential thickening and gas, perforated diverticulitis

pt2: inflammatory mass

pt3: diverticulitis, no perforation

pt4: inflammation, localized luminal air, numerous diverticula

Conservatively

Pt2: (patient's symptoms resolved relatively quickly and because the patient had no sign of free perforation on imaging)

Pt3: patient's age and other comorbidities)

28

pt1: 79/F

pt2: 87/F

pt3: 77/M

pt1: Abd pain

pt2: Abd pain

pt3: Abd pain

AXR: pt1, Abd CT: pt1-4

AXR: pt1: N

Abd CT: pt1: colonic diverticulosis and scattered jejunal and ileal diverticula, ​jejunal diverticulitis

pt2: scattered jejunum and ileum diverticulum, two extraluminal foci of air, perforated diverticulitis

pt3: multiple colonic diverticula, small obstructed diverticulitis

pt1: Surgery

pt2: Conservatively and surgery

Pt3: Not reported

29

74/M

Abd pain, nausea and flatulence

Exp laparotomy

Exp laparotomy: multiple jejunal diverticula, ruptured diverticula, peritonitis

Laparotomy: jejunal segment resection, and anastomosis (suspicion of perforation)

30

83/F

Abd pain

CXR, Abd CT

CXR: no free subdiaphragmatic gas Abd CT: multiple diverticula and free gas

Laparotomy: jejunal segment resection, and anastomosis (perforation)

31

79/M

Abd pain

Abd CT

Abd CT: distal jejunal loop thickening and infiltration, free air

Laparotomy: jejunal segment resection, and anastomosis (perforation)

32

82/M

Abd pain and nausea

Abd CT

Abd CT: revealed fluid collection, air bubbles around the duodenum

Conservatively (patient’s age, absence of peritonitis, and stable clinical condition)