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Diverticulitis is inflammation and/or infection of a diverticulum, which can result in phlegmon of the bowel wall, Peritonitis, Acute Perforation of the GI Tract, fistula, or Intra-Abdominal Abscesses. The primary symptom is abdominal pain. Diagnosis is by CT. Treatment is with bowel rest, sometimes antibiotics, and occasionally surgery.
A colonic diverticulum is a saclike pouch of colonic mucosa and submucosa that protrudes through the muscular layer of the colon; because it does not contain all layers of the bowel, it is considered a pseudodiverticulum (see also Definition of Diverticular Disease). Many people have multiple colonic diverticula (Colonic Diverticulosis). The incidence of diverticulosis rises with increasing age; it is present in three quarters of people > 80 years.
Diverticula are usually asymptomatic but sometimes become inflamed (diverticulitis). A 2013 study reported that 4.3% of patients with documented diverticulosis developed diverticulitis over an 11-year follow-up period (Risk references).
Diverticulitis that is managed nonoperatively can recur as either an acute or chronic process. The risk of a recurrent acute episode is up to 39%, although reported rates vary widely (Risk references). A large population-based study found that after an episode of acute diverticulitis the recurrence rate at 1 year was 8% and at 10 years was 22% (Risk references). About half of second episodes of diverticulitis occur within 12 months. In some patients, however, recurrence manifests as chronic, ongoing abdominal pain; this may develop after one or more acute episodes.
Last modified in- ByJoel A. Baum