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Small bowel diverticula: diagnosis
Last reviewed: 23.04.2024
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Diagnosis of diverticulum of the duodenum is mainly based on the data of contrast X-ray examination (including indications and duodenography) and gastroduodenoscopy results. However, in this case, the endoscopist should be warned not only about examining the bulb of the duodenum (as is often the case, since in most cases, the main pathological processes, for example peptic ulcers, are most often localized in the bulb of the duodenum and in the stomach, besides endoscopic examination of the whole duodenal ulcer requires additional time, complicates, and in some cases complicates the study), but try to examine the entire duodenum.
If properly carried out by an experienced expert, endoscopy is very important in identifying and describing the nature of the opening in the diverticulum, the state of the mucous membrane around it, in some cases the diverticulum itself, establishing its exact dimensions, and the presence or absence of residual contents in it. With the development of inflammatory processes in the diverticula, endoscopic examination determines pronounced edema, flushing, erosion or ulceration of their mucous membrane, covered with white coating. It should be emphasized that, in severe diverticulitis with ulceration, endoscopic examination should be performed with extreme caution in order to avoid the possibility of causing bleeding or perforation of the diverticulum. In some cases, large diverticula, filled with food, fluid and air, are detected with ultrasound or computer tomography, often conducted entirely on other indications.
Diagnosis of diverticulum of the jejunum and ileum. The main method for detecting diverticular disease of the small intestine is X-ray. To reveal the diverticulum of the ileum is very difficult and in the absence of complications, since it is poorly filled with contrasting mass. In addition, X-ray examination of the small intestine because of the peculiarities of its location is often difficult. If the diverticulum is filled with a suspension of barium sulphate, it has the appearance of a blind process that extends from the ileum.
Meckel's diverticulum can sometimes be identified with laparoscopy. In acute surgical complications caused by the diverticulum of the ileum, an accurate diagnosis can be established only during the operation.
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