Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...
diverticulosis.pptx by ; shaheed Alaamry
1.
2.
3. • Diverticular disease of the colon is an important cause of
hospital admissions and a significant contributor to
healthcare costs in Western and industrial societies
4. • The prevalence of diverticulosis is age-dependent,
increasing from less than 20 percent at age 40 to 60
percent by age 60
5.
6. Western and industrialized nations have prevalence rates of 5 to
45 percent.
Approximately 95 percent of patients with diverticula have
sigmoid diverticula .
in both Black patients and White patients were located in the
sigmoid colon, the distribution of the diverticula in the ascending
colon or hepatic flexure was higher in Black patients as
compared with White patients (20 versus 8 percent).
Editor's Notes
Abnormal colonic motility is an important predisposing factor in the development diverticula. Patients with diverticulosis have exaggerated segmentation contractions in which segmental muscular contractions separate the lumen into chambers (image 3). It is hypothesized that the increase in intraluminal pressure predisposes to herniation of mucosa and submucosa. The neural basis for the abnormal motility observed in patients with diverticulosis remains unclear, although one report found that a central event appeared to be upregulation of smooth muscle M3 receptors [59,60].
Since the sigmoid colon is the segment of the colon with the smallest diameter, it is the site of the highest pressure during segmentation of the colon [61]. Additional structural changes may also decrease resistance of the wall to intraluminal pressure. As an example, most patients with sigmoid diverticula exhibit thickening of the circular muscle layer, shortening of the taeniae, and luminal narrowing. There is no hypertrophy or hyperplasia of the bowel wall, but increased elastin deposition is found in the taeniae
The underlying cause of diverticulitis is micro- or macroscopic perforation of a diverticulum. It was previously believed that obstruction of diverticula (eg, by fecaliths) increased diverticular pressure and caused perforation. However, such obstruction is now thought to be rare (picture 3 and picture 1) [36]. The primary process is thought to be erosion of the diverticular wall by increased intraluminal pressure or inspissated food particles. Inflammation and focal necrosis ensue, resulting in perforation.
