42. Diverticula of the GI tract Flashcards Preview

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Flashcards in 42. Diverticula of the GI tract Deck (25):
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

3

Most diverticula are (2)

1. acquired
2. false

4

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

7

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

9

Diverticulosis - symptoms / complication

symptoms --> often asympotmatic or vague discomfort complication --> diverticular bleeding ( painless hematoscezia ) b. diverticulitis

10

Diverticulitis - definition and presentation

diverticulosis with inflamed microperforations classically causing LLQ pain, fever, leukocytosis

11

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)

13

• 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

19

• Diverticulitis classically causes pain in what region of the abdomen?

The left lower quadrant (most commonly occurs in the sigmoid colon)

20

• 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

21

• 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)

22

• 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

25

• A patient has symptoms similar to appendicitis but instead has the pain on the left side. What is highest on your differential?

Diverticulitis (left-sided appendicitis)

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