Abstract
While small bowel diverticulosis, particularly, ileal diverticulitis is rare and often asymptomatic, it can lead to chronic vague symptoms or acute complications. Acute presentations may mimic appendicitis, small bowel obstruction, or colonic diverticulitis but can also appear with atypical symptoms, making diagnosis challenging. In many cases, definitive diagnosis relies on imaging such as abdominal CT, which can identify features like extraluminal air or mass lesions, though surgical exploration may be required in complex cases. Small bowel diverticula are structural outpouchings of the intestinal wall, typically located on the mesenteric border, and are more common in men with a male-to-female ratio of 2:1. They are predominantly found in the proximal jejunum (75 %), followed by the distal jejunum (20 %) and ileum (5 %). Complications such as obstruction, perforation, and localized peritonitis may occur, necessitating prompt surgical intervention. Management of uncomplicated cases typically involves bowel rest, intravenous fluids, and antibiotics. For complicated cases, resection of the affected bowel segment with primary anastomosis is the treatment of choice. Early recognition and timely surgical intervention are crucial to preventing severe morbidity and mortality associated with this rare condition.