Difference between revisions of "Diverticular disease"
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| Line 36: | Line 36: | ||
Complications: | Complications: | ||
*Diverticulitis. | *Diverticulitis. | ||
*Diverticular-associated colitis<ref name=pmid19581849>{{Cite journal | last1 = Mulhall | first1 = AM. | last2 = Mahid | first2 = SS. | last3 = Petras | first3 = RE. | last4 = Galandiuk | first4 = S. | title = Diverticular disease associated with inflammatory bowel disease-like colitis: a systematic review. | journal = Dis Colon Rectum | volume = 52 | issue = 6 | pages = 1072-9 | month = Jun | year = 2009 | doi = 10.1007/DCR.0b013e31819ef79a | PMID = 19581849 }}</ref> - | *Peformation - [[peritonitis]]. | ||
**Rectal biopsy to differentiate from [[ulcerative colitis]]. | *Diverticular-associated colitis - see below. | ||
===Diverticular-associated colitis=== | |||
Features:<ref name=pmid19581849>{{Cite journal | last1 = Mulhall | first1 = AM. | last2 = Mahid | first2 = SS. | last3 = Petras | first3 = RE. | last4 = Galandiuk | first4 = S. | title = Diverticular disease associated with inflammatory bowel disease-like colitis: a systematic review. | journal = Dis Colon Rectum | volume = 52 | issue = 6 | pages = 1072-9 | month = Jun | year = 2009 | doi = 10.1007/DCR.0b013e31819ef79a | PMID = 19581849 }}</ref> | |||
*Rare. | |||
*Definitions vary somewhat - one is: ''IBD-like inflammation restricted to areas with diverticular disease''. | |||
*Considerable overlap with IBD histologically (no definite histologic findings). | |||
*Rectal biopsy may be used to differentiate from [[ulcerative colitis]]. | |||
==Gross== | ==Gross== | ||
Revision as of 18:26, 1 November 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.
- Peformation - peritonitis.
- Diverticular-associated colitis - see below.
Diverticular-associated colitis
Features:[1]
- Rare.
- Definitions vary somewhat - one is: IBD-like inflammation restricted to areas with diverticular disease.
- Considerable overlap with IBD histologically (no definite histologic findings).
- Rectal biopsy may be used to differentiate from ulcerative colitis.
Gross
- Corrugated - like cardboard.
- Wall thickening (reactive).[2]
Endoscopic image
Diverticular disease. (WC/Samir)
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:
- Colorectal carcinoma - may cause a stricture, usually obvious on microscopy.
- Inflammatory bowel disease.
Images
Diverticular disease. (WC)
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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
- ↑ 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.
- ↑ 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.
- ↑ West, AB.. "The pathology of diverticulitis.". J Clin Gastroenterol 42 (10): 1137-8. doi:10.1097/MCG.0b013e3181862a9f. PMID 18936652.
- ↑ URL: http://histology-group28.wikispaces.com/DigestiveSystemProject. Accessed on: 23 August 2011.