Small bowel diverticula are a rare surgical entity and often remain asymptomatic until clinical presentation of perforation, inflammation, or obstruction. Their incidence in published reports ranges from 0.06–2.3% [
2]. They are commonly seen in elderly males in the 7
th decade of life. They are pseudodiverticula consisting of mucosal and submucosal protrusion through the muscle wall of the gastrointestinal tract. This contrasts with Meckel’s diverticulum, a true diverticulum, which includes the muscle layer as well as the protrusion [
3]. Their etiology remains nebulous, and theories include intestinal dyskinesia with damage to Auerbach’s plexus [
3,
4]. In this patient, diverticula were observed throughout the small and large intestine (
Figures 4,
–
6). Colonic diverticula have been reported in up to 60% of patients with small bowel diverticula [
1]. These are isolated incidents of sporadic small bowel diverticula in the duodenum, jejunum, or ileum but have never been reported throughout the small bowel with concomitant colonic diverticula. The small bowel diverticula were not resected as they were clinically asymptomatic. The paucity of a classification system for small bowel diverticula prevents a standardized approach to management [
5]. The Hinchey classification, commonly used in the management of colonic diverticula, affords surgeons a standardized approach to colonic diverticula. Most small intestinal diverticula are discovered incidentally during a laparotomy and often involve long segments of ileum or jejunum. Surgery is limited to managing diverticular complications, such as perforation or obstruction [
6,
7]. Extensive surgical resection is not the preferred option given the complications of short bowel syndrome. There have been 16 cases of small bowel diverticula published to date in English-language scientific literature [
6]. The published cases reported an age range of 29–87 years; at 90 years of age, the patient in this case report may be the oldest. To our knowledge, this is the 1
st case report where the patient had diverticula in the duodenum, jejunum, ileum as well as the colon. It is hoped that in future a classification system of small bowel diverticula will afford a standardized approach to their management. The patient in this case report presented with intestinal obstruction due to a sigmoid intussusception. Adult intussusception (
Figure 7) remains a rare clinical entity with an incidence of 5% of all cases, and it is responsible for 1–3% of intestinal obstruction [
8,
9]; 65% of adult colonic intussusception is due to malignancy. The most common malignancy is primary adenocarcinoma, then lymphoma, followed by metastatic adenocarcinoma [
10]. There have been sporadic reports of large lipomas or benign lymphadenopathy acting as a lead point [
8,
9]. Having a sigmoid diverticulum as the lead point, is truly a unique presentation. The management of adult colonic intussusception is surgical resection as there is usually an underlying malignancy acting as the lead point. This is usually undertaken en-bloc to prevent possible tumor seeding [
8,
9]. Reduction of the intussusception through colonoscopy or laparoscopy serves no useful purpose as the underlying malignancy needs to be surgically resected.