Small Bowel Diverticulosis: An Overlooked Entity

Small Bowel Diverticulosis and Jejunal Perforation in Marfan Syndrome

Marfan syndrome is an autosomal dominant disorder involving mutation in the FBN1 gene, which encodes fibrillin-1, a protein critical to maintain the integrity of connective tissue. A mutation in this gene can affect multiple organ systems, but it is not classically associated with gastrointestinal complications. We describe a man with Marfan syndrome with multiple small bowel diverticula leading to small intestinal bacterial overgrowth and recurrent small bowel perforations.

Kayexalate Intake (in Sorbitol) and Jejunal Diverticulitis, a Causative Role or an Innocent Bystander?

Small intestine diverticulosis is a rare entity that is asymptomatic in the majority of cases. However, it may cause serious complications, such as infection, hemorrhage, intestinal obstruction and diverticulitis. Kayexalate (sodium polystyrene sulfonate) in sorbitol has been associated with colonic necrosis and less frequently with upper gastrointestinal injuries in a subset of uremic patients treated for hyperkalemia. We report a case of jejunal diverticulosis with mucosal injury and diverticulitis in a uremic patient treated with Kayexalate and discuss the potential role of Kayexalate in the pathogenesis of diverticulitis.

Dysphagia [corrected] due to solitary jejunal diverticulum after free jejunal transfer for reconstruction of the cervical oesophagus

The free jejunal flap has been widely used in clinical practice for the restoration of the cervical oesophagus, but a variety of complications still pose problems. The purpose of this report is to present a rare complication of the jejunal flap. A diverticulum of the jejunal segment, causing severe dysphagia, occurred 4 years after flap transfer in a 50-year-old man who underwent oesophageal reconstruction due to severe stricture following caustic ingestion. The patient was treated successfully by resection of the diverticulum. When examining a patient with unidentified symptoms in the neck or dysphagia after cervical oesophageal reconstruction with free jejunal transplant the possibility of small bowel diverticula should be borne in mind in order to prevent serious life-threatening complications that may arise from it.