Diverticulosis and diverticulitis

Diverticulosis and diverticulitis Diverticulosis and diverticulitis are pictures of the so-called diverticular disease. [For diverticular disease means the presence of protrusions of the colon wall.] The diverticular disease can be framed according to the presence or absence of complications: Uncomplicated diverticular disease - Asymptomatic Diverticular disease (diverticulosis): is discovered incidentally while performing radiological or endoscopic procedures. It 'a very common condition and it is believed that, over 60 years, about half of the population is affected. It 'located in more than 2/3 of the cases the sigmoid colon, but can affect any colonic segment, and sometimes widespread. In most cases asymptomatic, it can sometimes cause symptoms similar to irritable bowel syndrome, with pain in the lower left quadrant, change in bowel habit, bloating, flatulence. - Diverticulitis: pain of varying intensity, located at the lower left quadrant and / or epigastrium, accompanied by change in bowel habit (constipation or diarrhea), fever, increased white blood cell count, urinary disorders. Diverticular disease COMPLICATED Clinical picture differently depending on the type of complication. For example, in the case of bowel perforation, the patient experiences sudden pain, sharp, violent, initially localized to the lower left quadrant, accompanied by obstipation, fever and increased white blood cells. You can see the following pictures acute: - Drilling - Bleeding - Occlusion - Stenosis - Fistula DIAGNOSIS - Coloproctologica visit: history, physical examination - Instrumental examinations: abdomen direct RX, RX double-contrast barium enema, colonoscopy, ultrasonography, CT THERAPY Dietetics: diet rich in fiber (whole grain foods, fruits, vegetables and bran), with the addition of supplements (methyl cellulose, mucilage, etc.). Medical: Infusion of liquids, antibiotics, antispasmodics and analgesics as needed Surgery: elective surgery consists of resection of the affected section of the diverticula. In complicated diverticulitis: - CT-guided transcutaneous drainage if you see an abscess - immediate resection + anastomosis (and possible proximal colostomy) - Colostomy + resection and proximal end of the distal stump (Hartmann's procedure) with closure of the stoma after 4-6 months. Whether the surgery elective and intervention in cases of complicated diverticulitis can be performed with a laparoscopic approach.