Diverticular disease: Pathology review
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Diverticular disease: Pathology review
Gastrointestinal system
Liver, gallbladder and pancreas disorders
Biliary atresia
Crigler-Najjar syndrome
Dubin-Johnson syndrome
Gilbert's syndrome
Rotor syndrome
Acute cholecystitis
Ascending cholangitis
Biliary colic
Cholangiocarcinoma
Chronic cholecystitis
Gallbladder cancer
Gallstone ileus
Gallstones
Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Autoimmune hepatitis
Benign liver tumors
Budd-Chiari syndrome
Cholestatic liver disease
Cirrhosis
Hemochromatosis
Hepatic encephalopathy
Hepatitis
Hepatocellular adenoma
Hepatocellular carcinoma
Jaundice
Neonatal hepatitis
Non-alcoholic fatty liver disease
Portal hypertension
Primary biliary cirrhosis
Primary sclerosing cholangitis
Reye syndrome
Wilson disease
Pancreatic neuroendocrine neoplasms
Zollinger-Ellison syndrome
Acute pancreatitis
Chronic pancreatitis
Pancreatic cancer
Pancreatic pseudocyst
Lower gastrointestinal tract disorders
Bowel obstruction
Gallstone ileus
Intestinal adhesions
Volvulus
Colorectal cancer
Colorectal polyps
Familial adenomatous polyposis
Gardner syndrome
Juvenile polyposis syndrome
Peutz-Jeghers syndrome
Gastroschisis
Hirschsprung disease
Imperforate anus
Intestinal atresia
Intestinal malrotation
Intussusception
Meckel diverticulum
Necrotizing enterocolitis
Omphalocele
Abdominal hernias
Femoral hernia
Inguinal hernia
Crohn disease
Microscopic colitis
Ulcerative colitis
Ischemic colitis
Small bowel ischemia and infarction
Celiac disease
Lactose intolerance
Protein losing enteropathy
Short bowel syndrome (NORD)
Small bowel bacterial overgrowth syndrome
Tropical sprue
Whipple's disease
Carcinoid syndrome
Appendicitis
Diverticulosis and diverticulitis
Gastroenteritis
Irritable bowel syndrome
Anal fissure
Anal fistula
Hemorrhoid
Rectal prolapse
Upper gastrointestinal tract disorders
Cleft lip and palate
Congenital diaphragmatic hernia
Esophageal web
Pyloric stenosis
Tracheoesophageal fistula
Achalasia
Barrett esophagus
Boerhaave syndrome
Diffuse esophageal spasm
Eosinophilic esophagitis (NORD)
Esophageal cancer
Gastroesophageal reflux disease (GERD)
Mallory-Weiss syndrome
Plummer-Vinson syndrome
Zenker diverticulum
Cyclic vomiting syndrome
Gastric cancer
Gastric dumping syndrome
Gastritis
Gastroenteritis
Gastroparesis
Peptic ulcer
Aphthous ulcers
Dental abscess
Dental caries disease
Gingivitis and periodontitis
Ludwig angina
Oral cancer
Oral candidiasis
Parotitis
Sialadenitis
Temporomandibular joint dysfunction
Warthin tumor
Gastrointestinal system pathology review
Appendicitis: Pathology review
Cirrhosis: Pathology review
Colorectal polyps and cancer: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diverticular disease: Pathology review
Esophageal disorders: Pathology review
Gallbladder disorders: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Malabsorption syndromes: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Pancreatitis: Pathology review
Viral hepatitis: Pathology review
Assessments
Diverticular disease: Pathology review
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Transcript
Content Reviewers
At the gastroenterology clinic, there is a 62- year- old male from Germany, named Karl, who came in for his regular colonoscopy.
He is totally asymptomatic, except for occasional vague abdominal discomfort after meals.
Next, a 65- year- old Native American named James came to the emergency department after two episodes of painlessly passing fresh, red blood in his stool.
Finally, Zendaya, a 78- year- old African- American female, was brought to the hospital from a nursing home by paramedics, due to a severe pain in the left lower abdomen which started this morning.
Her temperature was measured at 101.8°F or 38.8°C at the nursing home.
On further history, they all had diets low in fiber and high in fat and red meat and suffered from chronic constipation.
Zendaya’s nursing home attendant reports that lately her constipation has been even worse than usual; in fact, her last bowel movement was more than three days ago.
Karl, James and Zendaya all have diverticula in the colon.
Diverticula are small outpouchings that form along the walls of a hollow structure, most commonly, the large intestine.
According to their pathogenesis, diverticula can be broadly grouped into traction and pulsion diverticula.
Traction diverticula occur due to the pulling forces of an adjacent inflammatory site, resulting in scarring and outpouching of all layers of the intestinal wall.
These are also known as true diverticula.
Next, there’s pulsion diverticula, which are a result of high pressures created during a strained bowel movement.
The pressure pushes on the mucosa and submucosa until they bubble out through weak spots along the wall, like where a blood vessel penetrates the muscle layer of the intestine.
These are also known as false or pseudodiverticula since they don’t involve all layers of the intestinal wall.
For your exams, it’s important to know that, most of the time, diverticula in the large intestine, and particularly, the left and sigmoid colon, are pulsion or false diverticula.
Sources
- "Fundamentals of Pathology" H.A. Sattar (2017)
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Review article: the pathophysiology and medical management of diverticulosis and diverticular disease of the colon" Alimentary Pharmacology & Therapeutics (2015)
- "Management of lower gastrointestinal tract bleeding" Best Practice & Research Clinical Gastroenterology (2008)
- "Diverticulosis and Diverticulitis" Mayo Clinic Proceedings (2016)
- "Etiology and Pathophysiology of Diverticular Disease" Clinics in Colon and Rectal Surgery (2004)
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