Diverticular disease, diverticulosis Flashcards
Diverticulum
Out pouching of the gut wall
Usually due to increased pressure within the gut
Where is the most common location for a diverticulum
Sigmoid colon
Diverticular disease - cause
Low fibre intake
Diverticular disease - clinical features
Asymptomatic
Incidental finding
Stools are more liquid than solid
Only becomes symptomatic if complications are present
Diverticular disease - what is it?
Due to the low fibre intake, stools are more liquid than solid and an increase in intraluminal pressure is required to pump a liquid along the LI Small pouches (diverticula) develop in the bowel lining and push out through the bowel wall
Diverticular disease - investigations
Barium enema
Sigmoidoscopy
Diverticular disease - complications
Diverticulitis Peritonitis (rupture) Pericolic abscess (causes swinging fevers) Fistula Haemorrhage Stricture
Diverticulitis - what is it?
Inflammation of the diverticulum
ie - if diverticulum gets obstructed by faeces
Diverticulitis - clinical features
LIF pain Fever Altered bowel habit Nausea Vomiting Loss of appetite
Diverticulitis - investigations
Barium enema
Colonoscopy
Management of complications
Hartmann’s procedure
Percutaneous drainage - CT guided
Primary resection
Laparascopic lavage and drainage
Management if no complications
Oral antibiotics at home
Liquid diet
Hartmann’s procedure
Remove affected segment of colon and bring out a stoma bag onto the abdominal wall
Meckels diverticulum
Congenital
- due to incomplete regression of the utello-intestinal duct
Out pouch that develops a weak point of the intestine
Meckels diverticulum - rule of 2’s
2% of people have it
2 foot above the oleo-caecal valve
2 inches long
