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Difference between revisions of "Diverticular disease"
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→Biopsy with possible diverticular disease-associated colitis
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| Prognosis = | | Prognosis = | ||
| Other = | | Other = | ||
| ClinDDx = [[colorectal carcinoma]], epiploic appendagitis | | ClinDDx = [[colorectal carcinoma]], [[epiploic appendagitis]] | ||
| Tx = usually conservative, surgical resection (recurrent or perforating diverticulitis) | | Tx = usually conservative, surgical resection (recurrent or perforating diverticulitis) | ||
}} | }} | ||
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*Very common. | *Very common. | ||
*Typically seen in elderly patients - 50s and 60s. | *Typically seen in elderly patients - 50s and 60s. | ||
*Weakly associated with adenomatous polyps (odd ratio ~ 1.03) - probably due to shared causality (i.e. diet).<ref name=pmid2486634>{{Cite journal | last1 = Lim | first1 = YJ. | last2 = Nanto | first2 = S. | last3 = Masuyama | first3 = T. | last4 = Kohama | first4 = A. | last5 = Kodama | first5 = K. | last6 = Kitabatake | first6 = A. | last7 = Kamada | first7 = T. | title = [Evaluation of function of human collateral coronary arteries using myocardial contrast echocardiography]. | journal = J Cardiol | volume = 19 | issue = 4 | pages = 973-9 | month = Dec | year = 1989 | doi = | PMID = 2486634 }}</ref> | |||
Presentations: | Presentations: | ||
| Line 61: | Line 62: | ||
*Usually sigmoid colon. | *Usually sigmoid colon. | ||
**May be elsewhere, e.g. appendix.<ref name=pmid23323233>{{Cite journal | last1 = Sohn | first1 = TJ. | last2 = Chang | first2 = YS. | last3 = Kang | first3 = JH. | last4 = Kim | first4 = DH. | last5 = Lee | first5 = TS. | last6 = Han | first6 = JK. | last7 = Kim | first7 = SH. | last8 = Hong | first8 = YO. | title = Clinical characteristics of acute appendiceal diverticulitis. | journal = J Korean Surg Soc | volume = 84 | issue = 1 | pages = 33-7 | month = Jan | year = 2013 | doi = 10.4174/jkss.2013.84.1.33 | PMID = 23323233 }}</ref> | **May be elsewhere, e.g. appendix.<ref name=pmid23323233>{{Cite journal | last1 = Sohn | first1 = TJ. | last2 = Chang | first2 = YS. | last3 = Kang | first3 = JH. | last4 = Kim | first4 = DH. | last5 = Lee | first5 = TS. | last6 = Han | first6 = JK. | last7 = Kim | first7 = SH. | last8 = Hong | first8 = YO. | title = Clinical characteristics of acute appendiceal diverticulitis. | journal = J Korean Surg Soc | volume = 84 | issue = 1 | pages = 33-7 | month = Jan | year = 2013 | doi = 10.4174/jkss.2013.84.1.33 | PMID = 23323233 }}</ref> | ||
=== | ===Images=== | ||
<gallery>Image:Diverticulosis_2.jpg | Diverticular disease. (WC/Samir)</gallery> | <gallery> | ||
Image:Diverticulosis_2.jpg | Diverticular disease. (WC/Samir) | |||
Image:Sigmoid diverticulum (diagram).jpg | Drawing of sigmoid diverticula. (WC/Anpol42) | |||
</gallery> | |||
<!--===Radiologic=== | <!--===Radiologic=== | ||
*Bowel wall thickening<ref name=pmid3741003>{{Cite journal | last1 = Morris | first1 = J. | last2 = Stellato | first2 = TA. | last3 = Lieberman | first3 = J. | last4 = Haaga | first4 = JR. | title = The utility of computed tomography in colonic diverticulitis. | journal = Ann Surg | volume = 204 | issue = 2 | pages = 128-32 | month = Aug | year = 1986 | doi = | PMID = 3741003 }}</ref> --> | *Bowel wall thickening<ref name=pmid3741003>{{Cite journal | last1 = Morris | first1 = J. | last2 = Stellato | first2 = TA. | last3 = Lieberman | first3 = J. | last4 = Haaga | first4 = JR. | title = The utility of computed tomography in colonic diverticulitis. | journal = Ann Surg | volume = 204 | issue = 2 | pages = 128-32 | month = Aug | year = 1986 | doi = | PMID = 3741003 }}</ref> --> | ||
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- ONE LYMPH NODE NEGATIVE FOR MALIGNANCY ( 0 POSITIVE / 1 ). | - ONE LYMPH NODE NEGATIVE FOR MALIGNANCY ( 0 POSITIVE / 1 ). | ||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | ||
</pre> | |||
===Biopsy with possible ''diverticular disease-associated colitis''=== | |||
<pre> | |||
The endoscopy report describes diverticular disease. The general differential diagnosis for histologic colitis (infection, inflammatory conditions, ischemia, iatrogenic causes) should be considered. | |||
Inflammation restricted to areas with diverticular disease may be "diverticular disease-associated colitis". Clinical correlation is required. | |||
</pre> | </pre> | ||
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*[[Gastrointestinal pathology]]. | *[[Gastrointestinal pathology]]. | ||
*[[Inflammatory bowel disease]] (IBD). | *[[Inflammatory bowel disease]] (IBD). | ||
*[[Diversion colitis]]. | |||
==References== | ==References== | ||