Diverticular Disease-definitions

• Saccular outpocketings of the colonic wall– congenital– acquired

• Diverticulitis - acute• Diverticulosis - chronic• Complicated diverticulitis

– fistulae / obstruction– perforation / haemorrhage

Diverticular Disease - incidence

• developed world

• 20th centuary

• 10% Diverticular Disease at 40 years

• 60% at 80 years

Diverticular Disease-aetiology

• low bulk stool

• increased segmentation

• muscular hypertrophy

Diverticular Disease-anatomy

Diverticular Disease-distribution

Diverticular Disease-macroscopic

Diverticular Disease

Diverticular Disease-symptoms

• Diverticulosis– LIF pain

• Diverticulitis– left sided appendicitis

Diverticular Disease

• Chronic– carcinoma– crohns disease– uc– ibs

• Acute– PID

– ischaemic colitis

– appendicitis

– Crohns disease

Diverticular Disease

• Double contrast barium enema

• CT scanning

• colonoscopy

Diverticular Disease

Diverticular Disease

Diverticular Disease

Diverticular Disease

• Diverticulosis– diet– anticholinergics

Diverticular Disease

• Diverticulitis– Antibiotics– IVI– NG tube

Diverticular Disease-surgery

• Elective– fistulae

– stricture

– young

– recovery abscess

• Emergency– free perforation

– intrabdominal abscess

– bleeding

– bowel obstruction

Diverticular disease-surgery

• Elective– preoperative

preparation

– resection and anastomosis

• Emergency– resuscitation

– resection and colostomy