Disorders of the Gastrointestinal System, 2nd Edition
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true diverticula; pseudodiverticula affect only the mucosal layers and do not ex- tend into the muscle wall. Pseudodiver- ticula are more common in the Western world, likely because of a low-fiber diet. Meckel diverticulum is typically seen in those of Asian descent (Ghoulam, 2019). Diverticulitis may cause potentially fatal complications such as obstruction, infec- tion, or hemorrhage, especially in those who are immunocompromised (Ghoulam, 2019). Figure 11. Colon Diverticulum
CASE STUDY 11 Bradley is a 70-year-old retired nurse. Since his retirement, he has been active and healthy and has enjoyed traveling throughout the U.S. On a recent visit to his son in Arizona, he suddenly developed left lower quadrant abdominal pain and bloody diarrhea. Bradley’s son insisted on taking him to the emergency department for evaluation. The cause of Bradley’s rec- tal hemorrhage is determined to be di- All of the following are believed to contribute to the development of diverticulitis EXCEPT: a. A diet high in red meat. b. A diet high in sugar. c. A diet high in nuts and seeds. d. A diet low in fiber. Answer/Rationale: The correct answer is c. A low- fiber, high-sugar, high-red-meat verticulitis. Question diet is believed to contribute to the development of diverticular disease. Diverticular disease Diverticular disease is characterized by the GI tract’s diverticula (bulging pouch- es). These pouches push the mucosal lining through the surrounding muscle. Diverticula are most often found in the sigmoid colon but can develop anywhere from the proximal end of the pharynx to the anus (Ghoulam, 2019). Diverticulosis is the term used to iden- tify diverticula that do not cause bleed- ing or become inflamed. Diverticulitis is a condition in which the pouches become inflamed. Together, diverticulosis and di - verticulitis are referred to as diverticular disease (Pemberton, 2021). Meckel diverticulum involves all layers of the intestinal wall and is considered
Note . Melvil. (2013). Colon Diverticulum. https://commons. wikimedia.org/wiki/File:Colon_diverticulum.jpg. CC BY-SA 3.0. If complications occur, the patient ex- periences abdominal pain, often in the left lower quadrant; dark red melena (tarry stool); constipation; bloating; nausea and vomiting; and, in extreme cases, signs of sepsis. Complications may lead to perfo- rations, peritonitis, and bowel obstruction (Ghoulam, 2019). Diverticula are most likely caused by high pressure exerted on a portion of the GI wall where blood vessels enter. Undigested food and bacteria build up in the diverticular sac when diverticulitis occurs. The food and bacteria become a hard mass that stretches the sac, further
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