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At least 19 recordsLinked to original sources
PubMed1995

[Natural history of colonic diverticulosis].

Colonic diverticula are acquired herniations through the colonic wall. The diseases prevalence differs in various geographic areas and is strikingly correlated with age. In occidental population, its prevalence in autopsy series has risen from 5% to more than 50% within less than a century. The formation of diverticula includes two main factors: a high pressure gradient and a weakness in the colonic wall favored by a low fiber diet. Most people with colonic diverticula remain asymptomatic throughout life. A minority is prone to develop complications (mainly diverticulitis or gross hemorrhage). Recurrent attack will occur in 25%, the risk being enhanced after a second attack. Preventive treatment of complication has not been known yet.

Adult↗
PubMed1995

Cross linking of collagen is increased in colonic diverticulosis.

Development of colonic diverticulosis is a function of age and declining colonic wall mechanical strength. The latter is partly a consequence of changes in the collagen structure. Collagen from unaffected human colons (n = 20, age range 20-80 years) and those with colonic diverticulosis (n = 5, age range 67-80 years) were obtained at necropsy. The total collagen content was measured as the hydroxyproline content and cross linkage by collagen solubility in weak acid was studied. The colonic total collagen content was constant with age (mean (SD) 15.8 (0.3) mg/100 mg wet weight of tissue). The acid solubility of the collagen, however, increased after the age of 40 years: at over 60 years, colonic diverticulosis was associated with an increased acid solubility ratio compared with values in unaffected colons (15.3 (0.2); compared with 9.2 (0.2), p < 0.001). The cross linking of colonic collagen increases with age. These changes seem to be a factor in the aetiology of colonic diverticulosis.

Adult↗
PubMed1976

Pathogenesis of massively bleeding colonic diverticulosis: new observations.

Colonic diverticulosis is a common cause of acute severe rectal hemorrhage. The precise site of bleeding, etiology, and pathogenesis have not been previously identified. Arteriographic, microangiographic, and detailed histologic observations in 10 cases of massively bleeding colonic diverticulosis demonstrated strikingly consistent changes related to the characteristic angioarchitecture of colonic diverticula. These changes included: (1) asymmetric rupture of the vas rectum toward the lumen of the diverticulum precisely at its dome or its antimesenteric margin; (2) conspicuous eccentric intimal thickening of the vas rectum, often with thinning of the media and duplication of the internal elastic lamina at and near the bleeding point; and (3) general absence of diverticulitis. Comparison with control colonic diverticula suggests that traumatic factors arising within the diverticular or colonic lumen induce asymmetric intimal proliferation and segmental weakening of the associated vas rectum, predisposing to rupture and massive bleeding.

Adult↗
PubMed1994

Colonic diverticulosis in India: the changing scene.

BACKGROUND: The prevalence of colonic diverticulosis has a wide geographic and ethnic variation and has been considered to be quite low in India. This study was aimed at determining the prevalence of colonic diverticulosis in northern India based on barium enema examination in symptomatic patients. METHODS: All barium enema examinations performed between January 1985 and December 1991 were reviewed for the presence of colonic diverticulosis. Clinical data of such patients were retrieved. RESULTS: 51 (3.2%) of 1610 barium enema studies showed colonic diverticulosis. The frequency of diverticulosis in barium studies increased from 0.3% among subjects in the third decade to 32.4% in patients above 60 years. Most patients were city dwellers, vegetarians and belonged to the upper socio-economic stratum. Twenty patients (39.2%) presented with a complication; the spectrum of such patients was no different from that reported from the West. While the sigmoid colon was the commonest site of diverticuli, there was a relative preponderance of right sided diverticuli as compared to the Western experience. Seven patients with complications required surgical treatment, while the rest were managed conservatively. CONCLUSION: Colonic diverticulosis and its complications are not rare in India and should be considered in the differential diagnosis of abdominal disorders.

Adult↗
PubMedDate not supplied

Complicated colonic diverticulosis: surgical perspective from an Indian Centre.

INTRODUCTION: Colonic diverticulosis was previously uncommon in India but its incidence seems to have increased recently. Patients with the disease in developing countries are also underdiagnosed and are therefore more likely to present with complications needing operation. However there is a paucity of surgical data on the condition. METHOD: Between August 1996 and February 2005 we operated on 32 patients (28 males, 4 females mean age 60 years) with colonic diverticulosis and analysed their characteristics from a prospective database. We here with describe our experience. RESULTS: Operations for diverticular disease constituted 3% of all the colorectal operations we performed. The diverticula were in the sigmoid colon in 28 (88%) and also in the descending colon in 4 (12%). Twenty-four patients were symptomatic. Twenty-two patients were diagnosed before surgery, 8 at operation and the rest from resected specimens. Emergency operations were performed in 23 and elective procedures in 9 patients. Ten patients were operated on for perforation and abscess, 8 for obstruction, 8 for colovesical fistula, 3 for peritonitis and 3 for haemorrhage. Emergency procedures were performed in 2 stages (resection plus a proximal diversion) in 20; unless done for bleeding in a stable patient where a primary anastomosis was done. One patient who had had an emergency procedure died of sepsis and ketoacidosis in the post-operative period. The 8 patients with colovesical fistulae were all males, had only sigmoid involvement and had had symptoms for a longer duration than the 24 without fistulae. CONCLUSIONS: Although operations for colonic diverticulosis still form a small proportion of the total number of colorectal operations, the diagnosis is often delayed till complications ensue and thus patients usually require emergency procedures. Males with long standing symptoms and sigmoid diverticula may develop colovesical fistulae.

Adult↗
PubMed1997

[Complicated colonic diverticulosis].

A clinical course of complicated colonic diverticulosis in 91 patients is analysed. There were marked symptoms of the disease in 35 patients, complicated clinical course--in 38 patients, and mild symptoms--in 18 patients. The complicated clinical course occurred in 12 patients with acute diverticulitis, in 6 patients with perforation of the diverticulum, in 10 patients with bleeding, in 9 patients with the ileus, in 1 patient with the enteric fistula. 2 patients died after the surgery because of peritonitis. The difficulties of the differential diagnosis, the role of roentgenologic and endoscopic methods of examination are described. Surgical policy in complicated colonic diverticulosis is discussed.

Adult↗
PubMedDate not supplied

[Use of an x-ray method in the assessment of changes in the intestinal wall in colonic diverticulosis].

The authors analyze x-ray findings in 194 patients with colonic diverticulosis and its inflammatory complications. Findings of preoperative irrigoscopy were correlated with dates of morphological investigations. Roentgenomorphological and functional changes were assessed in different clinical types of colonic diverticulosis. Correlation was received between this changes and clinical sings of disease. Authors determined risk-groups of inflammatory complications of colonic diverticulosis.

Calcinosis↗
PubMed2004

Prevalence and distribution of the colonic diverticulosis. Review of 417 cases from Lower Silesia in Poland.

BACKGROUND: The prevalence of colonic diverticulosis increases with age and is the most common pathology of the large bowel in the elderly. Studies of the frequency of colon diverticulosis are performed in necroptic, radiological and endoscopic surveys. AIM: The assessment of the prevalence and distribution of colonic diverticulosis evaluated with barium enemas. MATERIAL AND METHODS: 1,912 consecutive barium enemas examinations, performed between 1999-2002 were reviewed. The patients were 1,228 females and 684 males (mean age 55.4 yrs). RESULTS: Diverticula were observed in 21.7 percent (417) of the patients (279 females /mean age 64.1/ and 138 males /mean age 64.5 yrs). The prevalence of diverticulosis among females was 22.7 percent and among males 20.2 percent. The frequency of diverticulosis in patients aged 30-39 years was 5.3 percent, 40-49 years - 8.7 percent, 50-59 years - 19.4 percent, 60-69 years - 29.6 percent, 70-79 years - 40.2 per cent, and in those aged over 80 years it was 57.9 percent. CONCLUSIONS: Diverticular disease of the colon is a significant problem in elderly patients, both females and males. The most common occurrence is in the sigmoid and descending colon.

Adolescent↗
PubMed2005

An analysis of the development of colonic diverticulosis in the Japanese.

PURPOSE: There are quite different characteristics between colonic diverticulosis in the West and that in Asia, including Japan. These differences include the predominance of a few diverticula over others, right-sidedness, young generation, male, and few complications. In Japan, colonic diverticulosis started increasing in the 1970s. This study was performed to obtain exact evidence of diverticular development in contemporary Japanese by observing changes in diverticula in the same individuals examined over a period of ten or more years. METHODS: This study included 82 subjects (56 (68 percent) males and 26 (32 percent) females) who underwent barium enema examinations repeatedly for more than ten years from 1982 to 2000. The diverticula were categorized according to their location in the colon: right, left, or bilateral. They were also categorized by whether they appeared individually, were scattered with two to nine diverticula, or were numerous with ten or more diverticula. RESULTS: At the beginning of observation, the most frequent location was the right side (55; 67 percent), followed by bilateral (20; 24 percent) and the left side (7; 9 percent). Ten or more years later, the number on the right side had decreased to 39 (48 percent). The number of bilateral diverticula had increased to 38 (46 percent), and the number on the left had barely changed, to 5 (6 percent). The number of diverticula increased from 253 to 604 (239 percent) in the right and from 380 to 929 (244 percent) in the bilateral. The initially very small number in the left increased from 9 to 48 (533 percent). The data show marked increases in the right and bilateral diverticula, and also the spread from the right side to the left side. CONCLUSION: In contemporary Japanese, although the right predominated initially, diverticulosis showed a strong tendency to increase and spread from the right to the bilateral. The number of bilateral diverticula also tended to increase. The left did not change much.

Adult↗
PubMed1993

Epidemiological evaluation of colonic diverticulosis and dietary fiber in Japan.

The incidence of colonic diverticulosis was examined in 5 hospitals geographically isolated from each other in Japan during the period between mid '70s and 1986. The incidence rapidly increased in all hospitals from 3.5-9.0% in mid '70s and 8.4-23.2% in 1986. The ratio of right-sided type colonic diverticulosis was approximately 70-80% in each hospital and the ratio did not fluctuate significantly during the period. Birth cohort analysis revealed that although the incidence of right-sided diverticula had increased with aging, in groups born in more recent decades right-sided diverticula appeared in younger age than other groups. It was suggested that environmental factors rather than congenital factors may cause the increase of the incidence of right-sided colon diverticula.

Adult↗