Atlas of Gastroenterological Endoscopy
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Sigmoid diverticulosis Sigmoid diverticulum - filled with feces Scarr after diverticulitis
Sigmoid diverticulosis Sigmoid diverticulum - filled with stool Scarr after diverticulitis
Diverticula are predominantly acquired pouches of the intestinal wall showing a rising incidence with age (up to 60% in individuals >60 years). There are ethnical differences. In western countries the main cause is a diet deficient in fiber. Typical localisation is the sigma, but the right- sided colon and cecum can also be affected. Typical picture of stool retention in a diverticulum. Retained stool is a local irritant to the intestinal wall and favours bacterial overgrowth, thus potentially leading to diverticulitis. To prevent perforation the endoscopist must be careful to discriminate a diverticulum from the proper intestinal lumen. At the hepatic flexure a slightly inflamed mucosal fold is found. Just next to the fold there is a diverticulum with a web- like structure inside. The patient had a history of frequent bouts of divericulitis, thus this structure has to be interpreted as sequelae of inflammation.