Difference between revisions of "Diverticular disease"

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'''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'''.


===General===
==General==
*Very common.
*Very common.
*Typically seen in elderly patients - 50s and 60s.


Complications:
Complications:
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**Rectal biopsy to differentiate from [[ulcerative colitis]].
**Rectal biopsy to differentiate from [[ulcerative colitis]].


===Gross===
==Gross==
*Corrugated - like cardboard.
*Corrugated - like cardboard.
*Wall thickening (reactive).<ref name=pmid21359889>{{Cite journal  | last1 = Nicholson | first1 = BD. | last2 = Hyland | first2 = R. | last3 = Rembacken | first3 = BJ. | last4 = Denyer | first4 = M. | last5 = Hull | first5 = MA. | last6 = Tolan | first6 = DJ. | title = Colonoscopy for colonic wall thickening at computed tomography: a worthwhile pursuit? | journal = Surg Endosc | volume = 25 | issue = 8 | pages = 2586-91 | month = Aug | year = 2011 | doi = 10.1007/s00464-011-1591-7 | PMID = 21359889 }}</ref>
*Wall thickening (reactive).<ref name=pmid21359889>{{Cite journal  | last1 = Nicholson | first1 = BD. | last2 = Hyland | first2 = R. | last3 = Rembacken | first3 = BJ. | last4 = Denyer | first4 = M. | last5 = Hull | first5 = MA. | last6 = Tolan | first6 = DJ. | title = Colonoscopy for colonic wall thickening at computed tomography: a worthwhile pursuit? | journal = Surg Endosc | volume = 25 | issue = 8 | pages = 2586-91 | month = Aug | year = 2011 | doi = 10.1007/s00464-011-1591-7 | PMID = 21359889 }}</ref>


====Endoscopic image====
===Endoscopic image===
<gallery>Image:Diverticulosis_2.jpg | Diverticular disease. (WC/Samir)</gallery>
<gallery>Image:Diverticulosis_2.jpg | Diverticular disease. (WC/Samir)</gallery>


====Grossing notes====
===Grossing notes===
*[[pp:Diverticular disease]].
*[[pp:Diverticular disease]].


===Microscopic===
==Microscopic==
Features:
Features:
*Mucosa/submucosa invagination into the musuclaris propria (MP).
*Mucosa/submucosa invagination into the musuclaris propria (MP).
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*[http://histology-group28.wikispaces.com/file/view/divertic.jpg/60992930/divertic.jpg DD (wikispaces.com)].<ref>URL: [http://histology-group28.wikispaces.com/DigestiveSystemProject http://histology-group28.wikispaces.com/DigestiveSystemProject]. Accessed on: 23 August 2011.</ref>
*[http://histology-group28.wikispaces.com/file/view/divertic.jpg/60992930/divertic.jpg DD (wikispaces.com)].<ref>URL: [http://histology-group28.wikispaces.com/DigestiveSystemProject http://histology-group28.wikispaces.com/DigestiveSystemProject]. Accessed on: 23 August 2011.</ref>


===Sign out===
==Sign out==
<pre>
<pre>
RECTO-SIGMOID, LARGE BOWEL RESECTION:
RECTO-SIGMOID, LARGE BOWEL RESECTION:
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- NEGATIVE FOR MALIGNANCY.
- NEGATIVE FOR MALIGNANCY.
</pre>
</pre>


==See also==
==See also==

Revision as of 22:01, 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 peritonitis
Symptoms usu. asymptomatic, diverticulitis presents with abdominal pain
Clin. DDx colorectal carcinoma (occasionally)

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]

Image:

Sign out

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.