||Sigmoid diverticulum - filled with feces
||Scarr after diverticulitis
Diverticula are predominantly
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.
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.