Diverticula Disease

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Diverticular disease results in mucosal outpouches in the distal colon.
Diverticular disease causes herniation of the mucosa of the colon through the muscularis propria, producing outpouches of the bowel lumen.
There is thickening of the muscularis propria.
Complications are related to stagnation of contents of the diverticulae, with secondary inflammation. Acute diverticulitis is the result of acute inflammation of a diverticulum.
Haemorrhage may result or the diverticulum may rupture, leading to peritonitis or the development of a paracolic abscess.
Chronic inflammation may occur, with walling off of an area of inflammation by fibrous tissue.
The resulting scarring and inflammatory changes form a diverticular mass, which may cause large bowel obstruction and may mimic the appearances of a carcinoma of the colon on imaging.
Melanosis coli is associated with chronic laxative use Patients who take laxatives for constipation sometimes develop black coloration of the mucosa of the large bowel, termed 'melanosis coli'.
Histologically this is seen as accumulation of pigment-laden macrophages in the lamina propria of the colon.
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