What makes you tic: A comprehensive review of GI tract diverticular disease

Document Type: Review Article


1 Department of Diagnostic Radiology, University of California Irvine Medical Center, Orange, CA, USA

2 School of Medicine, University of California Irvine, CA, USA

3 Mallinckrodt Institute of Radiology, Washington University St Louis, St. Louis Missouri, USA

4 Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA

5 Chicago, IL, USA


Context: Diverticula are acquired or congenital outpouchings of the gastrointestinal tract, normally occurring at points of weakness in the wall of the alimentary canal. They can be present from esophagus to anus, with colonic diverticulosis accounting for the majority of cases. While often asymptomatic, diverticula of the gastrointestinal (GI) tract are clinically significant due to potential life-threatening complications. Familiarity with key epidemiologic, etiologic, clinical, imaging, and therapeutic features of various diverticula is therefore important. This review is meant to serve as a concise guide highlighting the distribution, epidemiology, presentation, classic imaging findings, and treatment for the spectrum of GI diverticula.

Evidence Acquisition: We review fluoroscopic, computed tomography (CT), and magnetic resonance imaging (MRI) features of the most commonly encountered GI diverticula. Diverticula that are anatomically adjacent often share features such as symptomatology, optimal diagnostic imaging modality, and management. Thus below we categorize them by location along the GI tract. Esophageal (Zenker’s, Killian-Jamieson, midthoracic, epiphrenic), false and true gastric, small bowel (duodenal, jejunoileal, and Meckel’s), and large bowel (appendiceal, cecal, ascending/descending/sigmoid colonic) diverticula are discussed.

Results and Conclusions: Although commonly incidental, diverticula of the GI tract can be clinically significant due to complications. This pictorial essay describes the epidemiologic, etiologic, clinical, and therapeutic features and imaging findings associated with GI diverticula encountered in clinical practice.