SEARCH RESULTS FOR: Acute-Diverticulitis

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Diverticulite Aigüe: Pathogenèse et Signes Cliniques diverticulite-aigue-pathogenese-et-signes-cliniques

Acute Diverticulitis

Acute Diverticulitis: Pathogenesis and clinical findings Low fiber diet Authors: Candace Chan Yan Yu Wayne Rosen* Reviewers: Laura Craig Noriyah AlAwadhi Danny Guo Erica Reed Maitreyi Raman* Claire Song Shahab Marzoughi * MD at time of publication ↓ Colonic motility ↑ Stool transit time Formation of small dry stool Stool build-up and ↑ strain with bowel movements ↑ Pressure in the colonic lumen Constipation (difficulty passing stool) Obstipation (inability to pass any feces) Inherent weakness in the muscle layers of the colonic wall associated with immature collagen fibers and diminished wall elasticity Mucosal and submucosal layers of the colon wall push through a weak spot of the circular muscle layer Formation of diverticulum (sac-like protrusion of the colonic wall) Continued stress on diverticula causes micro- perforations of the diverticulum Inflammation of diverticula Mesentery and pericolic fat (fat surrounding the colon) attempt to wall off inflammation or perforations Stool bacteria escapes the colon Formation of abscess (accumulation of pus in response to the bacteria ) Pro-inflammatory cytokine release from nearby adipose tissue Hypothalamic thermoregulatory center increases core temperature set point Fever Irritation of parietal peritoneum Inflamed vessels are more permeable and fluid leaks from colonic vessels into the abdominal cavity Chronic low-grade inflammation triggers activation of pro-fibrotic factors and fibroblasts Excess production of extracellular matrix proteins Stimulation of somatic nerves sends pain signals to the brain Lower left quadrant abdominal pain Peritoneal signs (abdominal guarding, rigidity, rebound tenderness) ↓ Total circulating blood volume ↑ heart rate ↓ Jugular venous pressure Orthostatic hypotension (low blood pressure when standing after sitting/lying down) Gastrointestinal strictures and/or colonic obstruction Accumulation of micro- perforations further weakens intestinal wall Complete bowel perforation (medical emergency) Development of an abnormal connection (fistula) through the bladder, vagina, skin, or gut Abscesses Accumulation of fibrotic tissue narrows the intestinal lumen Fibrosis of colon Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Re-Published Oct 4, 2024 on thecalgaryguide.com