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Diverticular Disease

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Coloproctology

Part of the book series: European Manual of Medicine ((EUROMANUAL))

Abstract

Colonic diverticulosis is among the most common diseases in developed Western countries, and its incidence is increasing as the average age of the population increases. Its etiology remains largely unknown. It is assumed that intestinal innervation disorders and structural alterations of the musculature induce abnormal contractile patterns with increased intraluminal pressure, thereby promoting the development of diverticula. The location of diverticula within the colon varies significantly among different regions of the world. In Western countries, primarily left-sided diverticulosis, particularly involving the sigmoid colon, has been well-described. This is in contrast to findings in Asia, where right-sided diverticulosis dominates. The actual prevalence of diverticulosis is difficult to determine because most individuals are asymptomatic. Acquired diverticular disease of the colon has been estimated to occur in 30 % of the population over the age of 45 years; 10–25 % of these individuals develop symptomatic diverticulitis. The clinical spectrum of diverticular disease varies from asymptomatic diverticulosis to symptomatic disease with potentially fatal complications, such as perforation or bleeding. Acute diverticulitis is treated according to severity. Computed tomography permits the complete evaluation of the location and extent of the inflammatory process, allowing appropriate, adapted clinical management. Treatment recommendations depend on the disease stage and include conservative approaches with observation and dietary modifications, as well as antibiotic treatment, abscess drainage, and surgery. A prerequisite for therapeutic decision making is an exact, comprehensive, and applicable classification of the disease before treatment. Several systems for classifying diverticular disease have been presented, but none of them has yet been universally adopted.

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Authors and Affiliations

  1. Department of General, Visceral and Vascular Surgery, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Christoph Holmer & Martin E. Kreis

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  1. Christoph Holmer
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  2. Martin E. Kreis
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Correspondence to Martin E. Kreis .

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Editors and Affiliations

  1. End- und Dickdarm-Zentrum Mannheim, Mannheim, Germany

    Alexander Herold

  2. Clinique de chirurgie digestive et endocrinienne, Institut des maladies de l’appareil digestif, Hotel Dieu, Nantes, France

    Paul-Antoine Lehur

  3. Chirurgische Klinik mit Poliklinik, Universitaet Erlangen, Erlangen, Germany

    Klaus E. Matzel

  4. UCD School of Medicine, St Vincent’s University Hospital, Dublin, Ireland

    P. Ronan O'Connell

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Holmer, C., Kreis, M.E. (2017). Diverticular Disease. In: Herold, A., Lehur, PA., Matzel, K., O'Connell, P. (eds) Coloproctology. European Manual of Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53210-2_17

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