Difference between revisions of "Diverticular disease"

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| Grossing  =  
| Grossing  =  
| Site      = [[colon]], other sites
| Site      = [[colon]], other sites
| Assdx      = diverticulitis, peritonitis
| Assdx      = diverticulitis, peritonitis, diverticular-associated [[colitis]]
| Syndromes  =
| Syndromes  =
| Clinicalhx =
| Clinicalhx =
Line 26: Line 26:
| Prognosis  =
| Prognosis  =
| Other      =
| Other      =
| ClinDDx    = [[colorectal carcinoma]] (occasionally)
| ClinDDx    = [[colorectal carcinoma]]
}}
}}
'''Diverticular disease''', also '''diverticulosis''', is a common disease of the [[colon]]. Inflammation of diverticula is known as '''diverticulitis'''.
'''Diverticular disease''', also '''diverticulosis''', is a common disease of the [[colon]]. Inflammation of diverticula is known as '''diverticulitis'''.
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*Mucosa/submucosa invagination into the musuclaris propria (MP).
*Mucosa/submucosa invagination into the musuclaris propria (MP).
**At the site the blood vessels supplying the mucosa and submucosa penetrate the MP.<ref name=pmid18936652>{{Cite journal  | last1 = West | first1 = AB. | title = The pathology of diverticulitis. | journal = J Clin Gastroenterol | volume = 42 | issue = 10 | pages = 1137-8 | month =  | year =  | doi = 10.1097/MCG.0b013e3181862a9f | PMID = 18936652 }}</ref>
**At the site the blood vessels supplying the mucosa and submucosa penetrate the MP.<ref name=pmid18936652>{{Cite journal  | last1 = West | first1 = AB. | title = The pathology of diverticulitis. | journal = J Clin Gastroenterol | volume = 42 | issue = 10 | pages = 1137-8 | month =  | year =  | doi = 10.1097/MCG.0b013e3181862a9f | PMID = 18936652 }}</ref>
DDx:
*[[Colorectal carcinoma]] - may cause a stricture, usually obvious on microscopy.
*[[Inflammatory bowel disease]].


===Images===  
===Images===  

Revision as of 22:07, 4 August 2013

Diverticular disease
Diagnosis in short

Diverticulum. H&E stain.

LM mucosa/submucosa invaginate into the musuclaris propria
Site colon, other sites

Associated Dx diverticulitis, peritonitis, diverticular-associated colitis
Symptoms usu. asymptomatic, diverticulitis presents with abdominal pain
Clin. DDx colorectal carcinoma

Diverticular disease, also diverticulosis, is a common disease of the colon. Inflammation of diverticula is known as diverticulitis.

General

  • Very common.
  • Typically seen in elderly patients - 50s and 60s.

Complications:

  • Diverticulitis.
  • Diverticular-associated colitis[1] - rare.

Gross

  • Corrugated - like cardboard.
  • Wall thickening (reactive).[2]

Endoscopic image

Grossing notes

Microscopic

Features:

  • Mucosa/submucosa invagination into the musuclaris propria (MP).
    • At the site the blood vessels supplying the mucosa and submucosa penetrate the MP.[3]

DDx:

Images

www:

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RECTO-SIGMOID, LARGE BOWEL RESECTION:
- PERFORATED DIVERTICULITIS WITH SEROSITIS AND ABSCESS FORMATION.
- SUBMUCOSAL FIBROSIS.
- ONE LYMPH NODE NEGATIVE FOR MALIGNANCY ( 0 POSITIVE / 1 ).
- NEGATIVE FOR MALIGNANCY.
SIGMOID COLON, SIGMOIDECTOMY:
- DIVERTICULAR DISEASE WITHOUT DIVERTICULITIS.
- NEGATIVE FOR MALIGNANCY.

See also

References

  1. Mulhall, AM.; Mahid, SS.; Petras, RE.; Galandiuk, S. (Jun 2009). "Diverticular disease associated with inflammatory bowel disease-like colitis: a systematic review.". Dis Colon Rectum 52 (6): 1072-9. doi:10.1007/DCR.0b013e31819ef79a. PMID 19581849.
  2. Nicholson, BD.; Hyland, R.; Rembacken, BJ.; Denyer, M.; Hull, MA.; Tolan, DJ. (Aug 2011). "Colonoscopy for colonic wall thickening at computed tomography: a worthwhile pursuit?". Surg Endosc 25 (8): 2586-91. doi:10.1007/s00464-011-1591-7. PMID 21359889.
  3. West, AB.. "The pathology of diverticulitis.". J Clin Gastroenterol 42 (10): 1137-8. doi:10.1097/MCG.0b013e3181862a9f. PMID 18936652.
  4. URL: http://histology-group28.wikispaces.com/DigestiveSystemProject. Accessed on: 23 August 2011.