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PubMed2003

[Diverticulosis: the dimensions of a growing problem].

The etiology of diverticulitis remains unexplained. One hypothesis postulates that a diet low in fiber results in low-volume feces, which in turn leads to a segmental increase in muscle tone with bulging of the mucosa. Diverticulitis then occurs through micro-/macroperforation of the resulting diverticulum. Four grades are distinguished ranging from local mesenteric inflammation (grade I) to fecal peritonitis (grade IV). Asymptomatic diverticulitis requires no treatment. Diverticular bleeding must be carefully distinguished from upper gastrointestinal tract bleeding, carcinoma, and angiodysplasia. In the case of symptomatic diverticulitis ("left-sided appendicitis") a differentiation must be made between the acute and chronic forms. The diagnosis of diverticulitis is based on laboratory findings, x-rays and CT scans. If chronic diverticulitis is suspected, it is important to exclude carcinoma of the colon. Whether treatment should be surgical or conservative will depend on the severity of the condition, and on the complications that may be expected with conservative therapy.

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