Atlas of Gastroenterological Endoscopy
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Diverticulitis Diverticulitis- early changes
Diverticulitis Diverticulitis Diverticulitis- early changes
A clinical picture of subileus necessitated coloscopy. In the sigmoid colon endoscopic signs of an acute diverticulitis are prominent ; i.e.: mucosal edema and a partial stenosis (left). Surrounding the diverticula erythematous mucosa is seen, mucosal capillaries are missing. A colonoscopy is performed for acute left lower quadrant pain. In the sigmoid colon a few diverticula with an erythematous ring around a fecolith can be seen. Early changes of a diverticulitis can be diagnosed. Such a fecolith is the starting off point for any diverticulitis. It causes mucosal errosions and a chronic inflammation This inflammation can progress to microperforation or localized phlegmonia.
Diverticulitis with inflammatory stenosis
Diverticulitis with inflammatory stenosis Inflammatory tumor of the sigma caused by diverticulitis, - here shown in remission - which has caused a stenosis. The mucous membrane around the diverticulosis is erythematous, vessels are rarified. Conservative therapy achieved complete remission of the diverticulitis and dilatation of the stenosis. In case of a suspected diverticulitis colonoscopy is contraindicated for risk of perforation. Stenose = stenosis
Diverticulitis with inflammatory stenosis An acute diverticulitis has developed into an inflammatory stenosis. An erythematous mucosa with interstitial edema is responsible for an extreme mucosal vulnerability. An endoscopic passaage is not possible. After antibiotic treatment a diverticulosis can be diagnosed, the endoscopic passage is smooth at the time of this second endoscopy.
Inflammatory pseudo- tumor
Inflammatory pseudo- tumor Colonoscopy was done for left- sided lower quadrant abdominal pain in a 34 year old patient. An ultrasound showed thickened colonic walls. Endoscopically an inflammatory pseudo- tumor obstructs the intenstinal lumen. After conservative antiinflamatory therapy a second look endoscopy revealed extensive diverticulosis as underlying disease. Diverticulitis in young patients is rare. See also endoscopic appearance.