Chronic small intestinal dysmotility presenting as jejunal diverticulosis with refractory malabsorption: role for partial enterectomy?

We read with interest the guidelines on the management of adult patients with severe chronic small intestinal dysmotility by Nightingale et al .1 Enteric myopathies can indeed manifest as jejunal diverticulosis, either acquired or congenital.2 Besides asymptomatic or acute complicated cases, chronic malabsorption due to bacterial overgrowth is a possible presentation of jejunal diverticulosis.3 As stated in the guidelines, this mechanism may lead to malnutrition or even intestinal failure.1 Although surgical options (resection, bypass or stoma formation) were discussed for pseudo-obstruction, resection of diverticula is usually not considered, as surgical outcomes of treatment-refractory cases have been rarely reported. We report here on our experience with a small series of patients with documented and refractory malabsorption due to small bowel diverticulosis who underwent partial enterectomy at the Leuven Intestinal Failure and Transplantation Centre (Leuven, Belgium) after consent. Bacterial overgrowth, steatorrhoea and medical treatment, including home parenteral nutrition (PN), were assessed. Median (range) time to referral and surgery, length …