Objective: Diverticular disease commonly affects the sigmoid colon in the West and the right colon in Asia. Perforation is uncommon affecting 4/100 000 per year. Perforated diverticular disease of the transverse colon is therefore very rare. We present a case of Crohns disease complicating transverse diverticular disease that lead to perforation and unfortunate death. Method: Radiological and histopathological features are presented with a review of the literature Results: To the best of our knowledge, this is the first reported case of Crohns disease complicating diverticular disease of the transverse colon. We suggest that distal stricturing leading to increased intraluminal pressure or increased weakening of the colonic wall due to coincident Crohns fissure and diverticulum are possible pathogenic mechanisms. Conclusion: Crohns disease complicating transverse diverticular disease is uncommon, but may be one pathogenesis leading to the rare event of transverse colon diverticular perforation. Results: There were 12 episodes in 9 patients. They start between day 7 and 499 (178±159 days). Duration ranged from 3 to 87 days (27±22). The three moderate and the three mild AR reversed with treatment. Of the 6 severe AR, 3 caused the failure of the graft. Five episodes de AR began as moderate or severe directly. Severity in the course of each episode was fluctuating. Sixteen indeterminate rejections were seen in 9 grafts (did not reach definitive criteria). They lasted 1-31 days (mean: 5±8 days). Conclusion: 1-Acute rejection is the most common cause of morbidity in the intestinal transplant (56 % of the grafts). 2-It can develop at any time and relapse. 3-The duration and severity of the episodes are fluctuating. 4-In our series, 75 % reversed, but severe rejection often lead to graft loss (50 %).