WHAT IS A DIVERTICLE?
divertucul is a sac-shaped protrusion formed on the wall of organs with a lumen (pipe-shaped), and can be likened to a short "dead end street". It may be acquired or congenital. It can be seen in the digestive tract, pharynx (pharynx), esophagus (esophagus), stomach, duodenum (duodenum), small intestine, large intestine and gallbladder.
The most common place where it is seen is the "large intestine".
HOW DOES A DIVERTICLE FORM?
With the contraction in a chamber, the intralumen pressure increases.
During the contraction, the fecal content in the lumen is expelled towards the distal end with relaxation at one end.
Inability to relax slowly or It causes half stool passage.
Complete isolation of these two chambers leads to the development of diverticula.
WHAT ARE THE CAUSES OF DIVERTICULA?
As the fiber content of the stool decreases, its volume decreases and it acquires a sticky feature. More effort is required to eliminate feces with these characteristics.
Diet rich in red meat and animal fat
Alcohol, cigarettes, caffeine
Some medications
WHAT ARE THE SYMPTOMS OF COLON DIVERTICULA?
abdominal pain
inability to relax after defecation
bloating
feeling of fullness
irregular bowel habit (periods alternating with diarrhea and constipation)
HOW IS COLON DIVERTICULA DIAGNOSED?
1-Barium double contrast colon radiography (its use has decreased greatly)
2-Colonoscopy (the most common diagnostic tool)
3-Computed Tomography
4-Ultrasonography
WHAT ARE THE COMPLICATIONS OF COLON DIVERTICLE?
Diverticulitis (25%); Inflammation occurring in the divertculus is the most common complication.
Bleeding (15%) is the second most common complication.
Perforation (puncture) can lead to intra-abdominal infections - abscesses
Abscess is the most common cause of perforation
br /> WHAT IS COLON DIVERTICULATE TREATMENT?
If the complications listed above develop in colon diverticula, clinical conditions requiring treatment occur. These may be characterized by acute and serious bleeding or serious intra-abdominal infection, and may also cause chronic clinical conditions. For treatments:
a- Medical treatment
Foods with high fiber content
Probiotics:
Antibiotics: Rifaximin…
Anti-inflammatory drugs: Mesalazine…
b- Surgical treatment
Recurrent diverticulitis attacks (complication rate in the 2nd attack increases to 50-60%)
Obstruction or leak formation
In cases where the distinction between diverticulitis and cancer cannot be made
Surgical treatment is required in patients under the age of 50 who have had a diverticulitis attack requiring hospitalization.
ALTERNATIVES TO SURGICAL INTERVENTION
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Primary resection + anastomosis, the part of the large intestine containing diverticula is removed (for example, the sigmoid colon) and the remaining large intestine ends are joined together, that is, anastomosed.
Hartmann procedure, Complication due to diverticulum (perforation). , abscess, etc.) develops. The part of the large intestine containing diverticula is removed, but the ends of the large intestine are not anastomosed, the upper end is mouthed to the skin, that is, a "colostomy" is applied, and the colostomy is closed after the event regresses.
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