acute diverticulitis (redirected from Weakened bowel wall)

acute diverticulitis,

a sudden severe, painful disorder of the intestinal tract, resulting from inflammation of one or more diverticula, or small pouches, in the wall of the bowel. The condition is typically diagnosed through x-rays and treated with antibiotics and/or surgically. If left untreated, the inflamed pouches may rupture, spilling fecal matter into the abdominal cavity and causing peritonitis.

---

acute diverticulitis

GI disease Acute inflammation of a diverticulum of the large–less commonly, small–intestine Staging See Hinchey staging Clinical Pain in hypogastrium, which localizes to the left lower quadrant; altered bowel habits–diarrhea > constipation, dysuria, urinary frequency, urgency–if affected segment is close to bladder Imaging CT is the diagnostic method of choice; it is safe, cost-effective, correlates with diagnosis of AD; false negative rate–2-21% Management First attack-liquid diet, 7-10 days of broad-spectrum antibiotics; for refractory AD, 'triple therapy' has been advocated, although newer broad-spectrum antibiotics–eg, pipericillin, tazobactam, may be as effective; CT-guided drainage is advocated for peridiverticular abscesses of > 5 cm3; ±20% of Pts with AD require surgery; in Pts who respond to medical management, and in whom diverticular abscesses can be controlled by percutaneous drainage, a single-stage procedure with 1º anastomosis is appropriate, and can be performed by laparoscopy; in emergencies, a 2-stage procedure with resection and colostomy in stage one, and reanastomosis in stage 2 is preferred See Diverticular disease

Acute diverticulitis–pathogenesis

↑ Intraluminal pressure

(IP ↓ stool bulk → ↑ GI transit time → ↑ IP; hypersegmentation and ↑IP result in herniation of colonic mucosa at weakened areas adjacent to the points of penetration of the vasa recta in the intestinal wall–which explains why diverticula are arranged in role

Weakened bowel wall

Once diverticula develop, undigested food may become entrapped; obstruction of the neck of the diverticulum sets the stage of distension as a result of mucus secretion; diverticula may consist solely of mucosa and thus are susceptible to vascular compromise

.