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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.
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 ...
Diverticulitis typically presents with lower quadrant abdominal pain of a sudden onset. [1] Patients commonly have elevated C-reactive protein and a high white blood cell count. [10] In Asia it is usually on the right (ascending colon), while in North America and Europe, the abdominal pain is usually on the left lower side (sigmoid colon).
Acute diverticulitis is thought to arise from either trauma or lack of blood flow to the existing diverticulum in the colon. The traumatic theory proposes that a fecalith, which is a hardened fecal matter, becomes trapped in a diverticulum, leading to colonic mucosa abrasion and local inflammation.
Diverticulosis often occurs in the sigmoid colon in association with increased intraluminal pressure and focal weakness in the colonic wall. It is a common cause of hematochezia . Volvulus occurs when a portion of the bowel twists around its mesentery, which can lead to obstruction and infarction .
Similarly, since the sigmoid colon is the smallest portion of the colon in diameter, it’s subject to relatively high pressures according the Laplace’s law, basically the spot in the large intestine where the walls get pushed on the hardest. The sigmoid colon is therefore where most diverticula form.
Large bowel (sigmoid colon) showing multiple diverticula: the diverticula appear on either side of the longitudinal muscle bundle (taenium). Colonic diverticulum Diverticulum of the urinary bladder of a 59-year-old man, transverse plane
Hinchey Classification is used to describe perforations of the colon due to diverticulitis. The classification was developed by Dr. E John Hinchey (1934–present), a general surgeon at the Montreal General Hospital and professor of surgery at McGill University. Diverticulosis (the presence of bowel diverticula) is an essentially ubiquitous ...
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