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Diverticula of the small intestine - Diagnosis
Last reviewed: 06.07.2025
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The diagnosis of duodenal diverticula is mainly based on the data of contrast radiographic examination (including duodenography when indicated) and the results of gastroduodenoscopy. However, the endoscopist should be warned about the need not to limit himself to examining only the duodenal bulb (as is often the case, since in most cases the main pathological processes, such as peptic ulcers, are most often localized in the duodenal bulb and in the stomach; in addition, endoscopic examination of the entire duodenum requires additional time, complicates, and in some cases complicates the examination), but to try to examine the entire duodenum.
When performed correctly by an experienced specialist, endoscopic examination is of great importance in identifying and describing the nature of the entrance to the diverticulum, the condition of the mucous membrane around it, and in some cases the diverticulum itself, establishing its exact dimensions, and the presence or absence of residual contents in it. When inflammatory processes develop in diverticula, endoscopic examination reveals pronounced edema, hyperemia, erosions or ulcerations of their mucous membrane covered with a white coating. It should be emphasized that in case of pronounced diverticulitis with ulceration, endoscopic examination must be carried out with extreme caution to avoid the possibility of causing bleeding or perforation of the diverticulum. In some cases, large diverticula filled with food contents, liquid and air are detected by ultrasound or computed tomography, often performed for completely different indications.
Diagnostics of diverticula of the jejunum and ileum. The main method of detecting diverticular disease of the small intestine is radiographic. It is very difficult to detect a diverticulum of the ileum even in the absence of complications, since it is poorly filled with a contrast mass. In addition, radiographic examination of the small intestine is often difficult due to the peculiarities of its location. If the diverticulum is filled with a suspension of barium sulfate, it has the appearance of a blind appendix extending from the ileum.
Meckel's diverticulum can sometimes be identified by laparoscopy. In acute surgical complications caused by ileal diverticulum, an accurate diagnosis can only be made during surgery.
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