tailieunhanh - Diverticular disease

Document introduction of content: Definitions, epidemiology, etiology, pathophysiology, medical and surgical management, other forms of diverticular disease, global aspects, references, useful web sites, WGO Practice Guidelines Committee members who contributed to this guideline. | WGO Practice Guidelines Diverticular disease 1 World Gastroenterology Organisation Practice Guidelines Diverticular Disease Core review team Dr. T. Murphy Prof. . Hunt Prof. M. Fried Dr. . Krabshuis Contents 1 Definitions 2 Epidemiology 3 Etiology 4 Pathophysiology 5 Medical and surgical management 6 Other forms of diverticular disease 7 Global aspects 8 References 9 Useful web sites 10 WGO Practice Guidelines Committee members who contributed to this guideline 11 Queries and feedback 1 Definitions Diverticulum A sac-like protrusion of mucosa through the muscular colonic wall 1 . Protrusion occurs in weak areas of the bowel wall through which blood vessels can penetrate. Typically 5-10 mm in size. Diverticula are really pseudodiverticular false diverticula as they contain only mucosa and submucosa covered by serosa. Diverticular disease consists of Diverticulosis the presence of diverticula within the colon Diverticulitis inflammation of a diverticulum Diverticular bleeding Types of diverticular disease World Gastroenterology Organisation 2007 WGO Practice Guidelines Diverticular disease 2 Simple 75 with no complications Complicated 25 with abscesses fistula obstruction peritonitis and sepsis 2 Epidemiology Prevalence by age 1 Age 40 5 Age 60 30 Age 80 65 Prevalence by sex Age 50 more common in males Age 50-70 slight preponderance in women Age 70 more common in women Diverticular disease in the young 40 Diverticular disease is far more frequent in older people with only 2-5 of cases occurring in those under 40 years of age. In this younger age group diverticular disease occurs more frequently in males with obesity being a major risk factor present in 84-96 of cases 2 3 . The diverticula are usually located in the sigmoid and or descending colon. Management of this subset of diverticular disease patients remains somewhat controversial. The concept of diverticular disease being a more virulent condition in the young remains widely debated. The natural history .