Diverticulosis natural history, complications and prognosis
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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.