Diverticular disease of the colon begins with diverticulosis: acquired outpouchings of the colonic mucosa through the muscular wall, which most often lie in the left colon and the sigmoid. Most people who have them never develop symptoms, and the outpouchings become steadily more common with age. The disease matters because a diverticulum can become inflamed — diverticulitis — or bleed, and these two complications carry almost all of its clinical weight.
Where to start
Start with the mechanism, then follow a patient through the clinic:
- Pathology and Pathogenesis — how and where diverticula form, and why the same weakness of the colonic wall underlies diverticulitis and diverticular bleeding.
- Clinical Manifestations — how asymptomatic diverticulosis, symptomatic uncomplicated diverticular disease and the two complications present.
- Diagnosis — why colonoscopy is avoided during an attack and how ultrasound and CT establish the diagnosis and its complications.
- Management — how uncomplicated and complicated diverticulitis and diverticular bleeding are treated, and how recurrence is prevented.