Flashcards in 42. Diverticula of the GI tract Deck (25)
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1
Diverticulum ?
Blind pouch protruding from the alimentary tract that communicates with lumen of the gut
2
MC area of diverticulum in Gi tract ( location )
sigmoid colon
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Most diverticula are (2)
1. acquired
2. false
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Diverticulum - true vs false
true --> all 3 gut wall layers outpouch
false --> only mucosa and submucosa
5
false diverticulum - occurs esp .... (where), also called
where vasa recta perforate muscularis externa aka pseudodiverticulum
6
Diverticulosis?
many false diverticula of the colon, commonly sigmoid
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Diverticulosis - frequency / associated with
common --> 50% of people over 60 associated with low fiber -diets
8
Diverticulosis - pathogenesis
increased intraluminal pressure and focal weakness in colonic wall
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Diverticulosis - symptoms / complication
symptoms --> often asympotmatic or vague discomfort complication --> diverticular bleeding ( painless hematoscezia ) b. diverticulitis
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Diverticulitis - definition and presentation
diverticulosis with inflamed microperforations classically causing LLQ pain, fever, leukocytosis
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Diverticulitis - treat with
-antibiotics
-percutaneous drainage or surgery if complicated
12
Diverticulitis - complicaton / tratment of com
1. abscess
2. fistula ( colovesical --> pneumaturia)
3. obstruction ( inflammatory stenosis)
4. perforation ( --> peritonitis)
treatment percutaneous drainage or surgery)
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• What is a diverticulum?
A blind pouch leading off of the alimentary tract that communicates with the lumen of the tract
14
• 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)
15
• A 62-year-old man with known diverticulosis has a screening colonoscopy. Where would you most expect to observe a diverticulum?
The sigmoid colon
16
• What is the etiology of diverticulosis?
Increased intraluminal pressure combined with focal weakness of the colonic wall
17
• A patient is concerned about her likelihood of developing diverticulosis. What dietary change do you suggest?
Increase the amount of dietary fiber
18
• A 57-year-old woman presents with vague abdominal discomfort and painless rectal bleeding. What is the most likely diagnosis?
Diverticulosis
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• Diverticulitis classically causes pain in what region of the abdomen?
The left lower quadrant (most commonly occurs in the sigmoid colon)
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• 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
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• 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)
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• After being diagnosed with diverticulitis, your patient asks about the mainstay of treatment. What do you respond?
Antibiotics, although surgery may be required
23
• A patient's vasa recta perforate the muscularis externa. What is the diagnosis?
Pseudodiverticulum or false diverticulum
24
• An 80-year-old woman has vague GI discomfort and hematochezia, along with many people her age. She will most likely have what diagnosis?
Diverticulosis
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