diverticular disease Flashcards
where are diverticula found
in colon
where are diverticula most common
sigmoid
what is diverticulosis
presence of diverticula
what is diverticulitis
inflamed diverticula
what is diverticular colitis
crescentic inflammation on the folds in areas of diverticulosis
how are diverticula formed
thickening of the muscle layer and because of high intraluminal pressures, pouches of mucosa extrude through the muscular wall through weakened areas near blood vessels
what are diverticular disease related to
low-fibre diet eaten in developed countries
when does diverticulitis occur
when faeces obstruct the neck of the diverticulum causing stagnation and allow bacteria to multiply
what can diverticulitis lead to
- bowel perforation
- abscess formation
- fistulae into adjacent organs
- haemorrhage
- peritonitis
how are diverticular found
incidentally on colonoscopy or barium enema examination
what type of diet helps diverticula
increase dietary fibre
symptoms of diverticular disease
- LIF pain
- erratic bowel habit
- severe pain
- constipation
what is investigation of choice
colonoscopy
what else is used for diagnosis
barium enema combined with flexible sigmoidoscopy
treatment
well balanced fibre diet with smooth muscle relaxants
what physiology is associated with diverticulitis
- altered gut motility
- increased luminal pressure
- disordered colonic microenvironment
where does acute diverticulitis affect
diverticula in the sigmoid colon
symptoms of diverticulitis
- severe pain in LIF
- fever
- constipation
- tachycardia
abdominal exam of diverticulitis
- tenderness
- guarding
- rigidity on left side of abdomen
- palpable mass on left side
what investigations are done for diverticulitis
- blood test
- CT colonography
- ultrasound
what does CT colonography show for diverticulitis
colonic wall thickening, diverticula and often pericolic collections and abscesses
treatment of diverticulitis
oral antibiotics such as ciprofloxacin and metronidazole
complications
- perforation
- fistula
- intestinal obstruction
- bleeding
- mucosal inflammation.