Diverticulosis Coli Research Articles

Diverticulitis and its Complications

Diverticulosis coli is the presence of acquired herniations of colonic mucosa through the muscular wall, with a covering of colonic serosa (Figure 1).

Diverticulosis coli and associations with concomitant diseases: An epidemiological study

Diverticulosis coli and associations with concomitant diseases: An epidemiological study

Diverticulosis coli and associations with concomitant diseases: An epidemiological study

Diverticulosis coli and associations with concomitant diseases: An epidemiological study

87-Year-Old Man With Macrocytic Anemia

An 87-year-old man was referred to our institution because of a 4-month history of progressive fatigue and orthostatic symptoms. Mild anemia (hemoglobin concentration, 11.1 g/dL) was noted 4 months before the onset of symptoms, but his hemoglobin concentration (14.0 g/ dL) was normal 15 months before that. He had no episodes of syncope but noticed poor exercise tolerance, making it difficult to continue bowling, his favorite pastime. No change was noted in appetite or weight, and he experienced no fever, chills, cough, chest pain, shortness of breath, palpitations, abdominal pain, or altered bowel pattern. The patient had no history of recurrent infections and was not aware of excessive bruising or any source of blood loss, particularly from the gastrointestinal or genitourinary tract. There was no history of recent blood transfusions, but he had taken iron supplements for a few weeks 1 year before presentation and continued to take a daily oral multivitamin with iron since that time. He denied taking any other medications. His medical history included sensorineural hearing loss, Gilbert disease, mild dependent edema, and diverticulosis coli. Physical examination revealed pronounced pallor. Orthostatic hypotension was noted, with an increase in his pulse rate from 62/min to 75/min and a decrease in systolic blood pressure from 120 mm Hg to 104 mm Hg from lying down to standing. The patient had no evidence of oropharyngeal abnormalities, excessive bruising, petechiae, lymphadenopathy, hepatosplenomegaly, or neuropathy. A trace of pitting edema was evident bilaterally on his lower extremities. Initial laboratory studies (reference ranges shown parenthetically) revealed a hemoglobin level of 6.9 g/dL (13.517.5 g/dL), mean corpuscular volume (MCV) of 115.6 fL (81.2-95.1 fL), leukocyte count of 4.3 × 10/L (3.5-10.5 × 10/L) with a normal leukocyte differential, and platelet count of 261 × 10/L (150-450 × 10/L) determined by an automated hematology analyzer.

Etiology and pathogenesis of diverticulosis coli: a new approach

The paper describes a hypothesis as to the etiology and pathogenesis of diverticulosis coli. Colonic diverticulosis develops as a result of excessive straining at defecation due to habitual bowel emptying in a sitting posture, which is typical of Western man. The magnitude of straining during habitual bowel emptying in a sitting posture is at least three-fold more than in a squatting posture and upon urge. The latter defecation posture is typical of latrine pit users in underdeveloped nations. The bowels of Western man are subjected to lifelong excessive pressures which result in protrusions of mucosa through the bowel wall at points of least resistance. This hypothesis is consistent with recent findings of elastosis of the bowel wall muscles, the distribution of diverticula along the colon, as well as with epidemiological data on the emergence of diverticulosis coli as a medical problem and its geographic prevalence.

Diverticulosis Coli in Association With Marfan's Syndrome

To the Editor. —It has generally been held that gastrointestinal (GI) tract complications are not commonly associated with Marfan's syndrome. Review of the literature shows instances of diaphragmatic hernia,1inguinal hernia,2and perforation of the appendix3in patients suffering this condition. Recently, we treated a patient with diverticulosis of the colon in association with Marfan's syndrome. Report of a Case. —A 38-year-old woman who had ectopia lentis, arachnodactyly, and cardiovascular manifestations compatible with Marfan's syndrome was admitted to the Chaim Sheba Medical Center, Tel-Hashomer, Israel, for surgical repair of a huge thoracic aortic aneurysm. The patient's history included a valve replacement for aortic valve prolapse and abdominal aortic aneurysmectomy. The patient died shortly after the operation due to ventricular fibrillation and cardiac arrest. Autopsy disclosed thrombosis of the left circumflex coronary artery. The uninvolved segment of the thoracic aorta showed fragmentation of the elastic laminae of the

Diverticulosis coli in association with Marfan's syndrome

Diverticulosis coli in association with Marfan's syndrome

Diverticular disease of the colon: surgical perspectives in the past decade.

Review of 475 cases of diverticular disease of the colon emphasized needs to stratify patients into clinical categories. Of 223 cases of diverticulosis coli, had significant colonic complaints which received no attention. Of 198 emergency admissions for acute diverticulitis, only 16 required emergency surgery. Resection in the face of serious peritonitis is not advisable. Twenty-seven elective resections gave excellent results. Three subtotal colectomies were successfully done for major bleeding. Final focus was on determination of therapy groups: medical, surgery advisable, and surgery inevitable.

Colon Perforation After Kidney Transplantation

Between 1962 and 1977 approximately 2% of Denver kidney transplant patients developed colon perforation. The single commonest cause was diverticulitis of the left colon (6/13 cases). In spite of drastic reduction or discontinuation of immunosuppression, only 5/13 patients survived for more than 90 days after operation. Analysis of this experience suggests that the high mortality rate associated with this complication can be reduced by early operation which removes the perforation from the peritoneal cavity (either exteriorization or resection) without primary intestinal reanastomosis. We believe that candidates for kidney transplantation with a history of previously symptomatic diverticulosis coli should have elective colon resection prior to transplantation. Any kidney transplant patient with lower abdominal signs should be investigated and treated aggressively.

3. A Case of Diverticulitis Coli with Stenosis of Sigmoid Colon

In recent two years 43 cases of diverticular disease have been found at our cinic, of 740 cases examined with barium enema. 3 cases of 43 cases were operated, one was at the right side and other two were at sigmoid colon.A case of diverticulitis coli with stenosis of sigmoid colon is reported in this paper. The patient was a 57-year-old man with a complaint of disturbance of defecation. He was already diagnosed of diverticulosis coli 2 year before, and had been used to be well with drug treatment. He noticed again the same symptom at this time, and consulted our clinic. On the films of barium enema, severe stenosis of the sigmoid colon was found, and after this examination he had suffered from high fever for a week. On the endoscopical examination, neither tumor nor ulceration revealed, and the mucosa relatively smooth, but the lumen of the colon was severely narrowed. So that diagnosis of signosis of sigmoid cancer was negated from the endoscopic findings. Radiographically, diverticula were seen on the whole tract of the colon, especially at the ceacal and sigmoid portion.From the clinical course and symptom, surgical treatment was indicated, so subtotal colectomy was performed. A tumor of the size of the fist formed at sigma of the resected specimen, of which surface of the section, increased muscular layer and the development of fatty tissue with microabscess formation were prominent.

The pathogenesis of diverticulosis coli

Summary The pathogenesis of colonic diverticulosis still is not well understood. It is believed that it is a combination of the degenerative process of aging, associated with spasm and increased intraluminal pressure. There is strong evidence to support the view that a muscle abnormality with shortening and hypertrophy precedes diverticulosis. An associated increase in the frequency and magnitude of spontaneous contractions causes an increase in internal pressure on the colon wall. Ultimately, this results in herniation and pouch formation. Once the diverticulum has herniated through the wall permanently, the continued increased pressure forces fecal contents into the pouch. This also causes vascular engorgement, necrosis of the mucosa, and bacterial penetration. The actual inflammation of diverticulitis results from perforation, rather than stagnation of fecal material. The shortening of the bowel, with spasm and thickening of the circular muscle, results in diverticular disease, and the common “spastic colon” may well be a precursor of diverticulosis coli.

Further experiences with Saint's triad (hiatus hernia, gallstones and diverticulosis coli).

Further experiences with Saint's triad (hiatus hernia, gallstones and diverticulosis coli).

SOME PATHOLOGIC CORRELATIONS OF OVARIAN STROMAL HYPERPLASIA

Six hundred autopsy cases were collected of adult women whose ovaries had been examined microscopically. Half these women had ovarian stromal hyperplasia, and half did not. Obesity, arteriolar nephrosclerosis, endometrial over growths and uterine leiomyomas were significantly more frequent in the women with ovarian stromal hyperplasia. The incidence of diabetes was related to the incidence of obesity, hypertension and nephrosclerosis, but these relationships were independent of the ovarian status. The occurrence of generalized arteriosclerosis, myocardial infarction and most other diseases was not significantly different in the two ovarian groups. Diverticulosis coli was more common inthe group without ovarian hyperplasia.

Some pathologic correlations of ovarian stromal hyperplasia.

Six hundred autopsy cases were collected of adult women whose ovaries had been examined microscopically. Half these women had ovarian stromal hyperplasia, and half did not. Obesity, arteriolar nephrosclerosis, endometrial over growths and uterine leiomyomas were significantly more frequent in the women with ovarian stromal hyperplasia. The incidence of diabetes was related to the incidence of obesity, hypertension and nephrosclerosis, but these relationships were independent of the ovarian status. The occurrence of generalized arteriosclerosis, myocardial infarction and most other diseases was not significantly different in the two ovarian groups. Diverticulosis coli was more common inthe group without ovarian hyperplasia.

Saint's triad (hiatus hernia, gall stones and diverticulosis coli): the problem of properly directing surgical therapy.

1. Routine clinical investigation of 170 adult patients with hiatus hernia revealed that 24 (14%) also had gall stones and diverticulosis coli (Saint’s triad). Comparison of this figure with information compiled from the literature suggests that, when a hiatus hernia patient is found to have either gall stones or diverticulosis, there is an excellent chance that the third disease is also present. 2. The therapeutic enigma of Saint’s triad in the present series revolved largely about non-critical assumption that it was the gall bladder disease which was responsible for the patient’s illness. The symptomatic results of cholecystectomy were notably poor.