Abstract

Why are Diverticula of the Rectum Uncommon? Angiomorphological Hypothesis

Highlights

  • The incidence of diverticula in the rectum is very low, ranging from 0.07 to 0.08% [1], compared to rates of 20 to 40% observed in the colon, despite the intra luminal pressures observed in the rectal lumen

  • We think that the lower incidence of diverticula in the mesocolic border of the colon is due to the fact that the vasa recta brevia (VRB) have a smaller caliber than the vasa recta longa (VRL), they cross more often the two muscle layers and, in the cases where they cross only the muscle circular layer, they have an oblique path for a longer tract

  • Diverticula are rare in the rectum for the various reasons already described and because the arteries that supply the rectum cross the wall of the organ in an oblique and longitudinal way, for a long tract

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Summary

Introduction

The incidence of diverticula in the rectum is very low, ranging from 0.07 to 0.08% [1], compared to rates of 20 to 40% observed in the colon, despite the intra luminal pressures observed in the rectal lumen. The etiology of rectal diverticula is still unknown [4] They occur in a higher frequency in the lateral wall of the rectum, where the longitudinal muscle layer is thinner. They are observed in 2 to 2.4% of the cases of colon diverticulosis [5] and occur sometimes associated with scleroderma. In order to explain the low incidence of rectal diverticula, several hypotheses have been proposed: the protection offered by the perirrectal muscle-fibrous structures, the presence of a continuous circumferential muscle layer (the circular and longitudinal muscle layers) and the lesser peristaltic activity in the rectum [2,4]

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