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Diverticulitis

Diverticulitis . Pathophysiology. Diverticula are small mucosal herniations protruding through the intestinal layers and the smooth muscle along the natural openings created by the vasa recta or nutrient vessels in the wall of the colon .

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Diverticulitis

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  1. Diverticulitis

  2. Pathophysiology • Diverticula are small mucosal herniations protruding through the intestinal layers and the smooth muscle along the natural openings created by the vasa recta or nutrient vessels in the wall of the colon. • These herniations create small pouches lined solely by mucosa. • Diverticula can occur anywhere in the gastrointestinal tract but are usually observed in the colon. The sigmoid colon has the highest intraluminal pressures and is most commonly affected

  3. Cont’d • Diverticulosis is defined as the condition of having uninflameddiverticula. The cause of diverticulosis is not yet conclusive, but it appears to be associated with a low-fiber diet, constipation, and obesity. • Diverticulitis is defined as an inflammation of one or more diverticula. Its pathogenesis remains unclear.  Fecal material or undigested food particles may collect in a diverticulum, causing obstruction.

  4. Cont’d • This obstruction may result in distension of the diverticula secondary to mucous secretion and overgrowth of normal colonic bacteria. • Vascular compromise and subsequent microperforation or macroperforation then ensue

  5. Clinical Manifestations • Left lower quadrant pain • Nausea • Vomiting • Constipation • Diarrhea • Flatulence • bloating. 

  6. Differential Diagnosis • Appendicitis • Cholecystitis • IBS • Biliary colic • IBD • Ovarian cyst • Pyelnephritis

  7. investigations • CBC • U & E • LFT • Urine analysis • Blood culture • CT

  8. Treatment • Medical therapy • antibiotics • Surgical therapy

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