Diverticulosis natural history, complications and prognosis: Difference between revisions
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==Natural History== | ==Natural History== | ||
Majority of patients with diverticula remain asymptomatic<ref name="pmid12603892">{{cite journal |vauthors=Simpson J, Spiller R |title=Colonic diverticular disease |journal=Clin Evid |volume= |issue=8 |pages=436–44 |year=2002 |pmid=12603892 |doi= |url=}}</ref>,it may progress to symptomatic disease based on the pathologic events. | Majority of patients with diverticula remain asymptomatic<ref name="pmid12603892">{{cite journal |vauthors=Simpson J, Spiller R |title=Colonic diverticular disease |journal=Clin Evid |volume= |issue=8 |pages=436–44 |year=2002 |pmid=12603892 |doi= |url=}}</ref>,it may progress to symptomatic disease based on the pathologic events. | ||
*'''Inflammation''' : ''Acute diverticulitis'' is defined if inflammation occures<ref name="pmid12603892">{{cite journal |vauthors=Simpson J, Spiller R |title=Colonic diverticular disease |journal=Clin Evid |volume= |issue=8 |pages=436–44 |year=2002 |pmid=12603892 |doi= |url=}}</ref><ref name="pmid1613298">{{cite journal |vauthors=Gore S, Shepherd NA, Wilkinson SP |title=Endoscopic crescentic fold disease of the sigmoid colon: the clinical and histopathological spectrum of a distinctive endoscopic appearance |journal=Int J Colorectal Dis |volume=7 |issue=2 |pages=76–81 |year=1992 |pmid=1613298 |doi= |url=}}</ref><ref name="pmid8540614">{{cite journal |vauthors=Makapugay LM, Dean PJ |title=Diverticular disease-associated chronic colitis |journal=Am. J. Surg. Pathol. |volume=20 |issue=1 |pages=94–102 |year=1996 |pmid=8540614 |doi= |url=}}</ref>. | *'''Inflammation''' : ''[[diverticulitis|Acute diverticulitis]]'' is defined if inflammation occures<ref name="pmid12603892">{{cite journal |vauthors=Simpson J, Spiller R |title=Colonic diverticular disease |journal=Clin Evid |volume= |issue=8 |pages=436–44 |year=2002 |pmid=12603892 |doi= |url=}}</ref><ref name="pmid1613298">{{cite journal |vauthors=Gore S, Shepherd NA, Wilkinson SP |title=Endoscopic crescentic fold disease of the sigmoid colon: the clinical and histopathological spectrum of a distinctive endoscopic appearance |journal=Int J Colorectal Dis |volume=7 |issue=2 |pages=76–81 |year=1992 |pmid=1613298 |doi= |url=}}</ref><ref name="pmid8540614">{{cite journal |vauthors=Makapugay LM, Dean PJ |title=Diverticular disease-associated chronic colitis |journal=Am. J. Surg. Pathol. |volume=20 |issue=1 |pages=94–102 |year=1996 |pmid=8540614 |doi= |url=}}</ref>. | ||
*'''Perforation''' : [[Lower Gastrointestinal Bleeding|''Lower GI Bleeding'']] is the most common consequence of diverticular perforation<ref name="pmid1085269">{{cite journal |vauthors=Meyers MA, Alonso DR, Gray GF, Baer JW |title=Pathogenesis of bleeding colonic diverticulosis |journal=Gastroenterology |volume=71 |issue=4 |pages=577–83 |year=1976 |pmid=1085269 |doi= |url=}}</ref><ref name="pmid4536683">{{cite journal |vauthors=Casarella WJ, Kanter IE, Seaman WB |title=Right-sided colonic diverticula as a cause of acute rectal hemorrhage |journal=N. Engl. J. Med. |volume=286 |issue=9 |pages=450–3 |year=1972 |pmid=4536683 |doi=10.1056/NEJM197203022860902 |url=}}</ref>. | *'''Perforation''' : [[Lower Gastrointestinal Bleeding|''Lower GI Bleeding'']] is the most common consequence of diverticular perforation<ref name="pmid1085269">{{cite journal |vauthors=Meyers MA, Alonso DR, Gray GF, Baer JW |title=Pathogenesis of bleeding colonic diverticulosis |journal=Gastroenterology |volume=71 |issue=4 |pages=577–83 |year=1976 |pmid=1085269 |doi= |url=}}</ref><ref name="pmid4536683">{{cite journal |vauthors=Casarella WJ, Kanter IE, Seaman WB |title=Right-sided colonic diverticula as a cause of acute rectal hemorrhage |journal=N. Engl. J. Med. |volume=286 |issue=9 |pages=450–3 |year=1972 |pmid=4536683 |doi=10.1056/NEJM197203022860902 |url=}}</ref>. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D.
Overview
Although the majority of patients with diverticula remain asymptomatic, approximately 10 to 25% of patients develop symptoms, which may range from abdominal pain to peritonitis[1].
Natural History
Majority of patients with diverticula remain asymptomatic[1],it may progress to symptomatic disease based on the pathologic events.
- Inflammation : Acute diverticulitis is defined if inflammation occures[1][2][3].
- Perforation : Lower GI Bleeding is the most common consequence of diverticular perforation[4][5].
Complications
Common complications associated with Diverticulosis include:
- Lower GI Bleeding[4][5].
- Acute Diverticulitis[1][2][3]
- Segmental Colitis[6]
Prognosis
Overall prognosis of Diverticulosis is excellent. Once the symptomatic disease occurs mortality rates vary depending on the presence of complications and patient comorbidities[7]. In patients with acute uncomplicated diverticulitis, conservative treatment is successful in 70 to 100 percent of patients and mortality is negligible[7].
References
- ↑ 1.0 1.1 1.2 1.3 Simpson J, Spiller R (2002). "Colonic diverticular disease". Clin Evid (8): 436–44. PMID 12603892.
- ↑ 2.0 2.1 Gore S, Shepherd NA, Wilkinson SP (1992). "Endoscopic crescentic fold disease of the sigmoid colon: the clinical and histopathological spectrum of a distinctive endoscopic appearance". Int J Colorectal Dis. 7 (2): 76–81. PMID 1613298.
- ↑ 3.0 3.1 Makapugay LM, Dean PJ (1996). "Diverticular disease-associated chronic colitis". Am. J. Surg. Pathol. 20 (1): 94–102. PMID 8540614.
- ↑ 4.0 4.1 Meyers MA, Alonso DR, Gray GF, Baer JW (1976). "Pathogenesis of bleeding colonic diverticulosis". Gastroenterology. 71 (4): 577–83. PMID 1085269.
- ↑ 5.0 5.1 Casarella WJ, Kanter IE, Seaman WB (1972). "Right-sided colonic diverticula as a cause of acute rectal hemorrhage". N. Engl. J. Med. 286 (9): 450–3. doi:10.1056/NEJM197203022860902. PMID 4536683.
- ↑ Ludeman L, Shepherd NA (2002). "What is diverticular colitis?". Pathology. 34 (6): 568–72. PMID 12555996.
- ↑ 7.0 7.1 Rafferty J, Shellito P, Hyman NH, Buie WD (2006). "Practice parameters for sigmoid diverticulitis". Dis. Colon Rectum. 49 (7): 939–44. doi:10.1007/s10350-006-0578-2. PMID 16741596.