||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
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
Conservative therapy achieved complete
remission of the diverticulitis and dilatation of the stenosis. In case of a suspected
diverticulitis colonoscopy is
for risk of perforation.
Stenose = 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
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
Diverticulitis in young patients is rare.
See also endoscopic appearance.