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Fecal calprotectin, a marker of colon inflammation, may be elevated. Computed tomography of the abdomen is not routinely necessary, but may show thickening or inflammation in the distal colon (sigmoid colon) with associated diverticulosis. Treatment may consist of antibiotics, aminosalicylates (mesalamine), or prednisone. In rare cases, surgery ...
CT scan showing extensive diverticulosis of the sigmoid colon Diverticular disease Whole slide of a transverse section of the left colon with diverticulosis. Diverticulosis is defined by the presence of multiple pouches (diverticula) in the colon. [22] In people without symptoms, these are usually found incidentally during other investigations.
Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days. [1] There may also be nausea, diarrhea or constipation. [1] Fever or blood in the stool suggests a complication. [1] People may experience a single attack, repeated attacks, or ongoing "smoldering" diverticulitis. [2] [4] [5]
Pancolitis or universal colitis, in its most general sense, refers to inflammation of the entire large intestine comprising the cecum, ascending, transverse, descending, sigmoid colon and rectum. It can be caused by a variety of things such as inflammatory bowel disease, more specifically a severe form of ulcerative colitis.
Unlike other diverticular diseases, SCAD symptoms spontaneously resolve on its own without or with very limited pharmaceutical intervention. Endoscopic evaluation and biopsy are needed for diagnosis. They should show evidence of inflammation in the mucosa in-between diverticula, with sparing of the rectum and proximal colon. [13]
The sigmoid colon is completely surrounded by peritoneum (and thus is not retroperitoneal), which forms a mesentery (sigmoid mesocolon), which diminishes in length from the center toward the ends of the loop, where it disappears, so that the loop is fixed at its junctions with the iliac colon and rectum, but enjoys a considerable range of movement in its central portion.
The disease is classified by the extent of involvement, depending on how far the disease extends: [14] proctitis (rectal inflammation), left sided colitis (inflammation extending to descending colon), and extensive colitis (inflammation proximal to the descending colon). [19] Proctosigmoiditis describes inflammation of the rectum and sigmoid colon.
[citation needed] Sigmoid volvulus is particularly common in elderly persons and constipated patients. Patients experience abdominal pain, distension, and absolute constipation. Cecal volvulus is slightly less common than sigmoid volvulus and is associated with symptoms of abdominal pain and small bowel obstruction.