Diverticulosis most common site -
Ans. is 'c' i.e., Sigmoid colon o Diverticulosis refers to presence of multiple diverticula,o Diverticula are of two types - (i) Congenital, and (ii) Acquired.Congenital diverticula : (the prototype of which is Meckel's diverticula) are not so common. They contain all the layers of the intestine are thus termed 'true' diverticula.Acquired diverticula : are the most common type. They are mainly 'false'diverticula as they do not contain all the layers of the intestinal wall.o They are mainly found in the colon (mainly the left side of colon) with sigmoid colon being the most common site. The next most common area involved is the descending colon. The diverticula are uncommon in the small intestine.Note: that in Asian countries, the main distribution of diverticula (up to 70%) is right-sided and may have a more genetic influence.o So unless otherwise specified a diverticulosis refers to the multiple false diverticula of the colon.Pathogenesis of acquired diverticulaAcquired diverticula are herniation or sac-like projection of the mucosa through the muscularis propria. The protrusion occurs commonly at the point where the nutrient artery penetrates through the muscularis propria, resulting in a break in the integrity of the colonic wall.Another factor necessary for the genesis of diverticula is increased intraluminal pressure. It has been postulated that diets low in fibre reduce the stoooi bulk which in turn leads to increased peristaltic activity, particularly in the sigmoid colon. This increases the intraluminal pressure.o Diverticulosis is common in the Western world. It's rare in the underdeveloped and developing countries, where diets include more fibre and roughage.Diverticulosis/DiverticulitisDiverticulitis meaning inflammation of the diverticula, is a complication of diverticulosis. Whereas diverticulosis is seen in nearly one-half of the individuals over the age of 60 yrs in western world, diverticulitis occurs in only about 20% of individuals with diverticulosis.DiagnosisThe diverticulosis could be demonstrated on barium enema. Characteristic 'saw-tooth ' appearance can be seen. But barium enema or colonoscopy should not be performed in acute settings because of high role of colonic perforation.y The diagnosis of diverticulitis is best made on CT scan.TreatmentTreatment is mainly medical (antibiotics, analgesia and bowel rest).Surgery is done for :o Who do not improve on medical therapyo Recurrent diverticulitiso In all patients with complicated diverticulitis (i.e. diverticulitis with abscess, obstruction, diffuse peritonitis, or fistulas)Surgery done in elective setting is :o A sigmoid colectomy wiih a primary anastomosis.
Ascending colon
Descending colon
Sigmoid colon
Transverse colon
Small & Large Intestine