Diverticular disease

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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]

Images

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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.