Diverticular disease Flashcards
Colonic diverticulum= ___ of the __ and sub __ through the weakened ___colon border
herniation
mucosa
submucosa
muscular
True diverticulum= an intestinal pocket with all the layers of the colon border (eg __ or __).
Meckel
appendix
Colon diverticulum is actually considered as ___ since the ___ layer is not involved
pseudodiverticula
muscular
The diverticulum occurs where the ___ penetrate through the __ layer of the colon. It happens only between ___ tenia to one of the two other on each side, It will never happen in the anti ___ side
artery
muscular
mesenteric
mesenteric
Diverticulosis is defined as the presence of a number of ____ and can be ___ or not
diverticula
symptomatic
The reasons for diverticula is ___ diet, low on ___, leading to long transit ___ time, bringing the intraluminal resting pressure to ___ levels
Western
fibers
colonic
high
The reason for the fact there are no diverticula in the rectum is that it surrounded by 360 degrees of longitude ___
muscles
Diverticula are uncommon in ___ patients, but 2/3 of patients at the age of __ have it.
young
80
The common areas diverticula are found are in the __ and __ colon
sigma
descending
The two manifestations of diverticular disease are: __ and __
bleeding
diverticulitis
Diverticular bleeding is ___ and can be seen as ___
painless
hematochezia
Diverticulitis is an ___ of the colonic diverticulum. Usually in the __ or __ colon. Found in -% of people with diverticula.
inflammation
descending
sigma
5-15%
In diverticulitis, there are micro ___, fecal extravasation, peri___ infection. The disease is extra___.
perforation
colic
luminal
The inflammation in diverticulosis is caused by ___ blocking the ___ of the diverticulum, coupled with __-__ limited to the ___.
Fecalith
neck
micro-perforation
mesocolon
The common clinical presentation of diverticulitis is ___ pain in the __ area with localized ___ sensitivity , __+__.
acute
LLQ
peritoneal
fever + leukocytosis
Less common diverticulitis signs may include: (5)
nausea
vomiting
ileus
diarrhea
Most diverticulitis patients will not suffer from ___, be managed ___, and most likely (__%) will not experience future __
complications
conservatively
80%
relapse
Complicated diverticulitis may include: (4)
abscess
fistula
perforation
bowel obstruction
In order to diagnose diverticulitis, we usually use __. It will help us to differentiate between ___ cases.
CT
complicated
Diverticulitis has a complete C/I for ___ enema, and ___
barium
colonoscopy
למחוק
למחוק
Large mesenteric abscess (>=__cm) will require __ and __ guided __
4
Abx
CT
drainage
Where diverticula can create fistulas to? (3)
bladder
vagina
sigma
HINCHEY classification:
class1: small localized peri__/__ __ . Treatment- __ +/- percutaneous __
abscess
colonic/mesenteric
Abx
drainage
HINCHEY classification:
class2: Large localized __ __. Treatment- ___ + percutaneous ___ or surgical ___
pelvic abscess Abx drainage exploration
HINCHEY classification:
class3: Generalized ___ ___. Treatment- LAP __ and conservative ___. If it gets complicated- ___
purulent peritonitis lavage monitoring Hartman
HINCHEY classification:
class4: Generalized ___ ___. Treatment- ___
fecal
peritonitis
Hartman
Patients with complicated abscess diverticulitis are now advised to go through ___ surgery and __ the sick colon __ weeks after the abscess has been drained
elective
remove
6
