Diverticular Disease (Diverticulosis and Diverticulitis)

Question 1

Diverticulosis ETIOLOGY?

Answer 1

Development of diverticula is associated with increased pressure in the bowel and
bowel wall weakness;

commonly seen in people > 60 years;

associated with low-fiber diet

Question 2

Diverticulitis ETIOLOGY?

Answer 2

Caused by inflammation of diverticula, usually by impacted fecal material

Question 3

Diverticula gross fx?

Answer 3

blind pouches leading off the alimentary tract that communicate with gut
lumen;

most commonly false (pulsion) diverticula: resulting from herniation of mucosa through defects in muscular layer;

less commonly true (traction) diverticula: consisting of mucosa, muscularis,
and serosa

Question 4

Diverticula histo fx?

Answer 4

Atrophic mucosa with thin muscularis propria

Question 5

What happens in Diverticulosis?

Answer 5

Presence of multiple diverticula most commonly in the sigmoid colon

Question 6

What happens in Diverticulitis?

Answer 6

Inflammation of diverticula with edema

Question 7

Diverticulosis clinical signs?

Answer 7

Usually asymptomatic,

but can present with:

1. vague abdominal discomfort
2. frank blood in the stool with no leukocytes or epithelial cells

Question 8

Diverticulitis clinical signs?

Answer 8

Presents with:
fever,
a chronic colicky LLQ abdominal pain,
and possibly bright red blood in the stool;

Question 9

Diverticulitis complications?

Answer 9

perforation,
abscess formation,
peritonitis
bowel stenosis

Question 10

Diverticulosis treatment?

Answer 10

High-fiber diet; psyllium fiber laxatives

Question 11

Diverticulitis treatment?

Answer 11

Antibiotics;
high-fiber diet;
consider colonic resection if multiple episodes of diverticulitis occur