Primary or secondary amyloidosis is commonly associated with dysmotility disorders of the large and small bowel and cases of diverticular disease have been described [13–15]. Despite small bowel diverticulosis seems to be acquired, two cases of familiar predisposition have been reported [16, 17]. The incidence of jejunoileal diverticula in studies of the small bowel by enteroclysis is 2-2.3% which is comparable to autopsy data presenting an incidence of 1.3-4.6% for diverticula of the jejunum and ileum [18–20]. The jejunoileal

diverticulosis is usually multiple, more frequently located in the jejunum and in the terminal ileum and probably due to the larger size of the vasa recta at these areas [20]. Eighty percent of diverticula occur in the jejunum, fifteen percent BI 2536 research buy in the ileum and five percent in both [1]. Isolated jejunal diverticulosis

coexists with diverticula of the esophagous (2%), of the duonenum (26%) and of the colon (35%) [21]. The prevalence increases with the age and the disease presents a peak incidence at the sixth and seventh decades with a male predominance [22]. The size of small bowel diverticula varies. Diverticula may measure from few millimeters up to more than 3 cm. Performing a web search of the relative literature for giant jejunal diverticula and using terms such as ‘giant jejunal divericula’, ‘giant jejunal diverticulosis’ and ‘giant jejunoileal diverticulosis’, we found a limited number of cases Torin 1 clinical trial defined from the author’s LOXO-101 ic50 description as giant; one case associated with Ehlers-Danlos Syndrome and malabsorption [8], one associated with iron deficiency [23], two cases with diverticultis [24, 25], one presented with intestinal obstruction [26] and one manifested with intestinal

bleeding [title only] [27]. The problem in our research was the fact that in many case reports as well as in larger series, CYTH4 there was no objective measurement of the size of the diverticulum (intraoperative or pathological). In many reports, the description of the diverticula was based on no medical terms (egg, golf ball etc) or it was not reported at all [28, 29]. Liu et al. [30] in a series of 27 patients reported jejunoileal diverticula greater than 3 cm in 12 cases not specifying the precise size of the reported diverticula. Despite this problem, we identified a giant divericula measuring about 26 cm in a young patient with peritonitis [abstract only] [31]. The disease is usually silent. Nevertheless, Rodrigez et al. [21] reviewed the literature and noted symptoms in 29% of the cases. Many symptoms may be misdiagnosed as dyspepsia or irritable small bowel. Edwards described a symptom triad observed in these patients as ‘flattulent dyspepsia’ (epigastric pain, abdominal discomfort, flatulence one or two hours after meals) [32].