| Diverticulitis |
Diverticulitis- early changes |
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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.
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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.
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| Diverticulitis with inflammatory stenosis |
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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 |
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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.
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| Inflammatory pseudo- tumor |
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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.
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