Diverticular_Disease

Diverticular_Disease - Diverticular Disease By Thanusha...

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Diverticular Disease By Thanusha Sithirapathy
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Introduction www.iecdesmoines.com/diverticular_disease.htm
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Introduction Diverticula in the colon are outpouchings of the mucous membrane, protruding through the muscle wall of the bowel These are also known as ‘false’ diverticula. Diverticular disease is most commonly found in the descending and sigmoid colon (95-98%). ~90% of people with diverticula have asymptomatic diverticulosis. Main complications - diverticulitis and lower GI bleeding. Have a significant mortality and morbidity. ‘Disease of The Western World’ - where typical diet is low in fibre and high in processed carbohydrates.
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Aetiology Precise aetiology unknown. High intraluminal pressure and a weak colonic wall (where blood vessels penetrate the muscularis) may predispose to herniation of the mucosa and submucosa. Abnormal colonic motility, defective muscular structure and defects in collagen consistency, usually due to ageing (eg. increased cross- linking and acid solubility of collagen) may also be causes. L-sided diverticular disease predominates in industrialised western societies. R-sided disease more common in Asians. Affects males and females equally Incidence increases with age. Diverticula occur in 50% of people over the age of 50yrs. Rare in people under 40yrs. Corticosteroid therapy (but not NSAID treatment) is thought to increase the risk of diverticulitis.
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Aetiology "Thumbprinting" is a radiological sign of thickening of the colonic wall (seen in left mid quadrant on this plain abdominal radiograph). It occurs secondary to submucosal haemorrhage oedema from capillary leakage. It can occur due to anything that leads to oedema of the bowel, including diverticular disease. www.emedicine.com/emerg/topic152.htm
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Pathogenesis Low-fibre diets distend the colon less than high- fibre diets high intramural pressures. Refined, low-fibre diets may also relate to
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Diverticular_Disease - Diverticular Disease By Thanusha...

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