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Colonic Diverticulosis
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Diverticular disease
              • Definitions

                • Outpouching of colonic mucosa and submucosa, most commonly in sigmoid colon
                • Myochosis coli is uncommonly used term to describe foreshortening of colon and circular muscle hypertrophy that commonly occurs along with diverticulosis

              IMAGING

              • General Features

                • Imaging Recommendations

                  • Fluoroscopic Findings

                    • Radiographic Findings

                      • CT Findings

                        • Ultrasonographic Findings

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Piscopo N et al: Diverticular disease: a review on pathophysiology and recent evidence. Ulster Med J. 89(2):83-8, 2020
                                                2. Weinrich JM et al: MDCT in the setting of suspected colonic diverticulitis: prevalence and diagnostic yield for diverticulitis and alternative diagnoses. AJR Am J Roentgenol. 215(1):39-49, 2020
                                                3. Feuerstein JD et al: Diverticulosis and diverticulitis. Mayo Clin Proc. 91(8):1094-104, 2016
                                                4. Aytac E et al: Risk of recurrence and long-term outcomes after colonic diverticular bleeding. Int J Colorectal Dis. 29(3):373-8, 2014
                                                5. Choi YH et al: Do we need colonoscopy following acute diverticulitis detected on computed tomography to exclude colorectal malignancy? Dig Dis Sci. 59(9):2236-42, 2014
                                                6. Humes DJ et al: Review article: the pathogenesis and management of acute colonic diverticulitis. Aliment Pharmacol Ther. 39(4):359-70, 2014
                                                7. Vanderstappen JH et al: A rare complication of colonic diverticulosis: giant diverticulum. Case report and overview of pathophysiology, diagnosis and therapeutic options. Acta Chir Belg. 114(3):206-8, 2014
                                                8. Hirata T et al: Association between colonic polyps and diverticular disease. World J Gastroenterol. 14(15):2411-3, 2008
                                                9. Martel J et al: History, incidence, and epidemiology of diverticulosis. J Clin Gastroenterol. 42(10):1125-7, 2008
                                                10. Meurs-Szojda MM et al: Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies. Int J Colorectal Dis. 23(10):979-84, 2008
                                                11. Morini S et al: Diverticulosis and colorectal cancer: between lights and shadows. J Clin Gastroenterol. 42(7):763-70, 2008
                                                12. Comparato G et al: Diverticular disease in the elderly. Dig Dis. 25(2):151-9, 2007
                                                13. Rispo A et al: Lower prevalence of diverticulosis in patients with ulcerative colitis. Dis Colon Rectum. 50(8):1164-8, 2007
                                                14. Brian West A: The pathology of diverticulosis: classical concepts and mucosal changes in diverticula. J Clin Gastroenterol. 40 Suppl 3:S126-31, 2006
                                                15. Dobbins C et al: The relationship of obesity to the complications of diverticular disease. Colorectal Dis. 8(1):37-40, 2006
                                                16. Krones CJ et al: The rare epidemiologic coincidence of diverticular disease and advanced colonic neoplasia. Int J Colorectal Dis. 21(1):18-24, 2006
                                                17. Sultan K et al: The nature of inflammatory bowel disease in patients with coexistent colonic diverticulosis. J Clin Gastroenterol. 40(4):317-21, 2006
                                                18. Gollub MJ et al: CT colonography features of sigmoid diverticular disease. Clin Imaging. 29(3):200-6, 2005
                                                19. Kang JY et al: Epidemiology and management of diverticular disease of the colon. Drugs Aging. 21(4):211-28, 2004
                                                20. Simpson J: Recent advances in diverticular disease. Curr Gastroenterol Rep. 6(5):417-22, 2004
                                                21. West AB et al: The pathology of diverticulosis coli. J Clin Gastroenterol. 38(5 Suppl):S11-6, 2004
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Synonyms

                                                              • Diverticular disease
                                                            • Definitions

                                                              • Outpouching of colonic mucosa and submucosa, most commonly in sigmoid colon
                                                              • Myochosis coli is uncommonly used term to describe foreshortening of colon and circular muscle hypertrophy that commonly occurs along with diverticulosis

                                                            IMAGING

                                                            • General Features

                                                              • Imaging Recommendations

                                                                • Fluoroscopic Findings

                                                                  • Radiographic Findings

                                                                    • CT Findings

                                                                      • Ultrasonographic Findings

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Piscopo N et al: Diverticular disease: a review on pathophysiology and recent evidence. Ulster Med J. 89(2):83-8, 2020
                                                                                              2. Weinrich JM et al: MDCT in the setting of suspected colonic diverticulitis: prevalence and diagnostic yield for diverticulitis and alternative diagnoses. AJR Am J Roentgenol. 215(1):39-49, 2020
                                                                                              3. Feuerstein JD et al: Diverticulosis and diverticulitis. Mayo Clin Proc. 91(8):1094-104, 2016
                                                                                              4. Aytac E et al: Risk of recurrence and long-term outcomes after colonic diverticular bleeding. Int J Colorectal Dis. 29(3):373-8, 2014
                                                                                              5. Choi YH et al: Do we need colonoscopy following acute diverticulitis detected on computed tomography to exclude colorectal malignancy? Dig Dis Sci. 59(9):2236-42, 2014
                                                                                              6. Humes DJ et al: Review article: the pathogenesis and management of acute colonic diverticulitis. Aliment Pharmacol Ther. 39(4):359-70, 2014
                                                                                              7. Vanderstappen JH et al: A rare complication of colonic diverticulosis: giant diverticulum. Case report and overview of pathophysiology, diagnosis and therapeutic options. Acta Chir Belg. 114(3):206-8, 2014
                                                                                              8. Hirata T et al: Association between colonic polyps and diverticular disease. World J Gastroenterol. 14(15):2411-3, 2008
                                                                                              9. Martel J et al: History, incidence, and epidemiology of diverticulosis. J Clin Gastroenterol. 42(10):1125-7, 2008
                                                                                              10. Meurs-Szojda MM et al: Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies. Int J Colorectal Dis. 23(10):979-84, 2008
                                                                                              11. Morini S et al: Diverticulosis and colorectal cancer: between lights and shadows. J Clin Gastroenterol. 42(7):763-70, 2008
                                                                                              12. Comparato G et al: Diverticular disease in the elderly. Dig Dis. 25(2):151-9, 2007
                                                                                              13. Rispo A et al: Lower prevalence of diverticulosis in patients with ulcerative colitis. Dis Colon Rectum. 50(8):1164-8, 2007
                                                                                              14. Brian West A: The pathology of diverticulosis: classical concepts and mucosal changes in diverticula. J Clin Gastroenterol. 40 Suppl 3:S126-31, 2006
                                                                                              15. Dobbins C et al: The relationship of obesity to the complications of diverticular disease. Colorectal Dis. 8(1):37-40, 2006
                                                                                              16. Krones CJ et al: The rare epidemiologic coincidence of diverticular disease and advanced colonic neoplasia. Int J Colorectal Dis. 21(1):18-24, 2006
                                                                                              17. Sultan K et al: The nature of inflammatory bowel disease in patients with coexistent colonic diverticulosis. J Clin Gastroenterol. 40(4):317-21, 2006
                                                                                              18. Gollub MJ et al: CT colonography features of sigmoid diverticular disease. Clin Imaging. 29(3):200-6, 2005
                                                                                              19. Kang JY et al: Epidemiology and management of diverticular disease of the colon. Drugs Aging. 21(4):211-28, 2004
                                                                                              20. Simpson J: Recent advances in diverticular disease. Curr Gastroenterol Rep. 6(5):417-22, 2004
                                                                                              21. West AB et al: The pathology of diverticulosis coli. J Clin Gastroenterol. 38(5 Suppl):S11-6, 2004