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Morphologic Basis for Developing Diverticular Disease, Diverticulitis, and Diverticular Bleeding

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Diverticula of the colon are pseudodiverticula defined by multiple outpouchings of the mucosal and submucosal layers penetrating through weak spots of the muscle coat along intramural blood vessels. A complete prolapse consists of a diverticular opening, a narrowed neck, and a thinned diverticular dome underneath the serosal covering.

The susceptibility of diverticula to inflammation is explained by local ischemia, translocation of pathogens due to retained stool, stercoral trauma by fecaliths, and microperforations.

Diverticular bleeding is due to an asymmetric rupture of distended vasa recta at the diverticular dome and not primarily linked to inflammation. Structural and functional changes of the bowel wall in diverticular disease comprise: i Altered amount, composition, and metabolism of connective tissue; ii Enteric myopathy with muscular thickening, deranged architecture, and altered myofilament composition; iii Enteric neuropathy sitez hypoganglionosis, neurotransmitter imbalance, deficiency of neurotrophic factors and nerve fiber remodeling; and Weddel Disturbed intestinal motility both in vivo increased intraluminal pressure, motility index, high-amplitude propagated contractions and in vitro altered spontaneous and pharmacologically triggered contractility.

Besides established etiologic factors, recent studies suggest that Icy hot Rodgau Free dating sites Wedel totally free concepts should be considered in the pathogenesis of diverticular disease. Diverticular disease ranges among the most common benign sitea of the gastrointestinal tract. Due to its high prevalence especially in the elderly, diverticular disease represents the 5th most important gastrointestinal disease in Datung countries in terms of direct and indirect costs with a mortality rate of 2.

In fact, a search in medical databases e. Thus, in spite of being a major healthcare problem with currently changing concepts of classification, diagnostic procedures, and clinical management as evidenced by the release of current guidelines [ 2 ], the pathogenesis of diverticular disease appears to be a rather neglected research field deserving more attention.

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Alterations of the enteric smooth musculature in diverticular disease. We are very pleased that you enjoyed your stay with us. Published online Apr 9.

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Morphologic Basis for Developing Diverticular Disease, Diverticulitis, and Diverticular Bleeding

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