surgical ppt

1. Wednesday,
April 12, 2023
1
Diverticulosis
DR. HIWA OMER AHMED
PROFESSOR IN GENERAL AND BARIATRIC
SURGERY
UNIVERSITY OF SULAIMANI
COLLEGE OF MEDICINE – SULAIMANI CITY-
KURDISTAN

2. Wednesday,
April 12, 2023
2
Diverticula
 Diverticula are small,
bulging pouches that can
form in the lining of the
digestive system. They
are found most often in
the lower part of the large
intestine (colon).
Diverticula are common,
especially after age 40,

3. Wednesday,
April 12, 2023
3
Diverticulosis and diverticulitis
 The presence of diverticula is known as diverticulosis
(die-vur-tik-yoo-LOE-sis).
 When one or more of the pouches become inflamed,
and in some cases infected, that condition is known as
diverticulitis (die-vur-tik-yoo-LIE-tis).
 Diverticulitis can cause severe abdominal pain, fever,
nausea and a marked change in the bowel habits.

4. Wednesday,
April 12, 2023
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Etiology
 Diverticulosis when naturally weak places in the colon give way
under pressure. This causes marble-sized pouches to protrude
through the colon wall.
 Diverticulitis occurs when diverticula traumatized or inflamed ,
resulting in inflammation, and in some cases, infection.

5. Wednesday,
April 12, 2023
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Risk factors
1. Aging. occurs in 10% of people over age 40 and in 50% of people over age 60.
The rate of diverticulosis increases with age, and it affects almost everyone over
age 80
2. Obesity.
3. Smoking.
4. Lack of exercise. Vigorous exercise appears to lower the risk of diverticulitis.
5. Diet high in animal fat and low in fiber.
6. Certain medications.
 steroids
 opioids
 NSAIDs, such as ibuprofen and naproxen sodium (Aleve).

6. Wednesday,
April 12, 2023
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The signs and symptoms
1. Pain, which may be constant and persist for several days. The
lower left side of the abdomen is the usual site of the pain.
Sometimes, however, the right side of the abdomen is more painful,
especially in people of Asian descent.
1. Nausea and vomiting.
2. Fever.
3. Abdominal tenderness.
4. Constipation or, less commonly, diarrhea.
5. Rectal bleeding

7. Wednesday,
April 12, 2023
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Complications
 About 25% of people with acute diverticulitis develop
complications, which may include:
1. An abscess, which occurs when pus collects in the
pouch.
2. A stricture formation.
3. A fistula between sections of bowel or the bowel and
other organs.
4. Peritonitis,
Peritonitis is a medical emergency and requires
immediate care.

8. Wednesday,
April 12, 2023
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Dx
 Investigations to exclude other causes of the pain
 US
 CT scan, can also indicate the severity of diverticulitis
and guide treatment.

9. Wednesday,
April 12, 2023
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Rx
 Non-complicated conservative
 Complicated surgery
1. For complications, such as abscess, fistula or obstruction, or perforation.
2. Multiple episodes of uncomplicated diverticulitis
3. Immunosuppressive patients
 Surgeries
1. Primary bowel resection.
2. Bowel resection with colostomy.