Editing Diverticular disease (section)

== '''Pathophysiology''' ==

* Diverticula - saccular     outpouching of the bowel wall
** Vast majority in the colon      are false diverticula containing only the mucosa and muscularis mucosae
* Formed by herniation     associated with zones of increased pressure within the colonic lumen
** Hypertrophy of the muscular      layers of the colon wall
** Narrowed lumen (especially      sigmoid)
** Disordered colonic motility
* Classically formed on the     mesenteric side of the colonic wall, where vasa recta traverse through the     muscular layer to provide blood to the mucosa
* Sigmoid and descending colon     most common areas, and rectum not affected
* Right-sided diverticulosis
** Common in Asian countries      but rare in the West
** Managed same as left sided
* Complications
** Diverticulitis
*** Diverticulum blocked by       fecalith or inspissated waste
*** Leads to stasis and       bacterial overgrowth, inflammation, and increased pressure within the       diverticulum
*** Can lead to ischaemia and       micro-perforation
** Bleeding
*** See LGIB topic
** Obstruction (chronic      stricture)