Flashcards in 42. Diverticula of the GI tract Deck (25)
Blind pouch protruding from the alimentary tract that communicates with lumen of the gut
MC area of diverticulum in Gi tract ( location )
Most diverticula are (2)
Diverticulum - true vs false
true --> all 3 gut wall layers outpouch
false --> only mucosa and submucosa
false diverticulum - occurs esp .... (where), also called
where vasa recta perforate muscularis externa aka pseudodiverticulum
many false diverticula of the colon, commonly sigmoid
Diverticulosis - frequency / associated with
common --> 50% of people over 60 associated with low fiber -diets
Diverticulosis - pathogenesis
increased intraluminal pressure and focal weakness in colonic wall
Diverticulosis - symptoms / complication
symptoms --> often asympotmatic or vague discomfort complication --> diverticular bleeding ( painless hematoscezia ) b. diverticulitis
Diverticulitis - definition and presentation
diverticulosis with inflamed microperforations classically causing LLQ pain, fever, leukocytosis
Diverticulitis - treat with
-percutaneous drainage or surgery if complicated
Diverticulitis - complicaton / tratment of com
2. fistula ( colovesical --> pneumaturia)
3. obstruction ( inflammatory stenosis)
4. perforation ( --> peritonitis)
treatment percutaneous drainage or surgery)
• What is a diverticulum?
A blind pouch leading off of the alimentary tract that communicates with the lumen of the tract
• What is the difference between a true diverticulum and a false diverticulum?
True diverticulum contains three layers (mucosa, submucosa, serosa), whereas false diverticulum contains only two layers (mucosa, submucosa)
• A 62-year-old man with known diverticulosis has a screening colonoscopy. Where would you most expect to observe a diverticulum?
The sigmoid colon
• What is the etiology of diverticulosis?
Increased intraluminal pressure combined with focal weakness of the colonic wall
• A patient is concerned about her likelihood of developing diverticulosis. What dietary change do you suggest?
Increase the amount of dietary fiber
• A 57-year-old woman presents with vague abdominal discomfort and painless rectal bleeding. What is the most likely diagnosis?
• Diverticulitis classically causes pain in what region of the abdomen?
The left lower quadrant (most commonly occurs in the sigmoid colon)
• A man with fevers and rectal bleeding is found to have diverticulitis. What are the four most common potential complications?
Perforation, peritonitis, abscess formation, and bowel stenosis
• A 73-y/o man admitted for LLQ pain and rectal bleeding develops pneumaturia on day 4 of hospitalization. What complication has occurred?
Colovesical fistula (one of the more common complications of diverticulitis)
• After being diagnosed with diverticulitis, your patient asks about the mainstay of treatment. What do you respond?
Antibiotics, although surgery may be required
• A patient's vasa recta perforate the muscularis externa. What is the diagnosis?
Pseudodiverticulum or false diverticulum
• An 80-year-old woman has vague GI discomfort and hematochezia, along with many people her age. She will most likely have what diagnosis?