This article is about the medical term. For the structures in sea slugs, see Diverticulum (gastropod).
Diverticulum
Other names
Diverticula
Schematic drawing of a false diverticulum. A - mucosa; B - submucosa; C - muscularis; D - serosa and subserosa
Specialty
Gastroenterology
In medicine or biology, a diverticulum is an outpouching of a hollow (or a fluid-filled) structure in the body.[1] Depending upon which layers of the structure are involved, diverticula are described as being either true or false.[2]
In medicine, the term usually implies the structure is not normally present. However, in embryology the term is used for some normal structures arising from others, as for instance the thyroid diverticulum, which arises from the tongue.[3]
The word comes from Latin dīverticulum, "bypath" or "byway."
Contents
1Classification
2Embryological
3Human pathology
3.1Gastrointestinal tract diverticula
3.2Genito-urinary tract diverticula
3.3Other diverticula
4See also
5Footnotes
6External links
Classification
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Diverticula are described as being true or false depending upon the layers involved:
True diverticula involve all layers of the structure, including muscularis propria and adventitia, such as Meckel's diverticulum.[2]
False diverticula (also known as "pseudodiverticula") do not involve muscular layers or adventitia. False diverticula, in the GI tract for instance, involve only the submucosa and mucosa.[2]
Embryological
The kidneys, originally diverticula in the development of the urinary and reproductive organs.
The lungs, originally diverticula forming off of the ventral foregut.[3]
The thymus appears in the form of two flask-shape diverticula, which arise from the third branchial pouch (pharyngeal pouch) of the endoderm.[4]
The thyroid gland develops as a diverticulum arising from a point on the tongue, demarcated as the foramen cecum.[3]
The 3 classifications of esophageal diverticula. 1-Pharyngeal (Zenker's) 2-Midesophageal 3-Epiphrenic
Human pathology
Gastrointestinal tract diverticula
Meckel's diverticulum: a persistent portion of the omphalomesenteric duct present in 2% of the population,[5] making it the most common congenital gastrointestinal malformation.[6]
Esophageal diverticula may occur in one of three areas of the esophagus:
Pharyngeal (Zenker's)- usually occurring in the elderly, through Killian's triangle above the cricopharyngeal muscle.
Midesophageal
Epiphrenic-due to dysfunction of the lower esophageal sphincter, as in achalasia.[7]
Killian-Jamieson diverticulum- is very similar to a pharyngeal esophageal diverticulum, differing in the fact that the pouching is below the cricopharyngeal muscle.[8]
Colonic diverticula: Although found incidentally during colonoscopy, these diverticula may become infected (see diverticulitis) and can perforate, requiring surgery.[9]
Duodenal and jejunal diverticul(um|a): are congenital lesions and may be a source of bacterial overgrowth. They may also perforate or result in abscesses.
Rokitansky-Aschoff sinuses are diverticula in the gallbladder due to chronic cholecystitis[10]
Gastric diverticula are very infrequent.[11]
Most of these pathological types of diverticulum are capable of harboring an enterolith. If the enterolith stays in place, it may cause no problems, but a large enterolith expelled from a diverticulum into the lumen can cause obstruction.[citation needed]
Genito-urinary tract diverticula
Calyceal diverticulum: usually asymptomatic, but if a stone becomes lodged in the outpouching they may present with pain.[12]
Bladder diverticulum: Balloon-like growths on the bladder commonly associated with a chronic outflow obstruction, such as benign prostatic hyperplasia in older males. Usually found in pairs on opposite sides of the bladder, bladder diverticula are often surgically removed to prevent infection, rupture, or even cancer.
Urethral diverticulum: Acquired diverticula are usually post-infectious in females,[13] whereas they are more likely to be congenital in males.[citation needed]
Other diverticula
Cardiac diverticulum: A very rare congenital malformation of the heart that is usually benign [14]
Diverticulum of Kommerell: is an out-pouching(aneurysm) of the aorta where an aberrant right subclavian artery is located.[15] It is unusual nomenclature, in that focal dilatations of a blood vessel are properly referred to as aneurysms.
Meckel's diverticulum
Large bowel (sigmoid colon) showing multiple diverticula. Note how the diverticula appear on either side of the longitudinal muscle bundle (taenium).
Colonic diverticulum
Diverticulum of urinary bladder of a 59-year-old man, transverse plane
Bladder diverticula containing stones. Also note that the bladder wall is thickened due to possible transitional cell carcinoma.
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Bladder diverticula as seen on ultrasound with doppler[16]
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Bladder diverticula as seen on ultrasound[16]
See also
Skeletal pneumaticity
Footnotes
^"diverticulum | Definition of diverticulum in English by Lexico Dictionaries". Lexico Dictionaries | English. Retrieved 2019-07-17.
^ abc), Courtney M. Townsend (Jr; Daniel Beauchamp, R.; Mark Evers, B.; Mattox, Kenneth L. (2017). Sabiston textbook of surgery : the biological basis of modern surgical practice. Townsend, Courtney M., Jr.,, Beauchamp, R. Daniel,, Evers, B. Mark, 1957-, Mattox, Kenneth L., 1938- (20th ed.). Philadelphia, PA. ISBN 9780323299879. OCLC 921338900.
^ abcSadler, T. W. (Thomas W.) (2012). Langman's medical embryology. Langman, Jan. (12th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781451113426. OCLC 732776409.
^Standring, Susan (2016). Gray's anatomy : the anatomical basis of clinical practice. Standring, Susan (41st ed.). [Philadelphia]. ISBN 9780702052309. OCLC 920806541.
^Elsayes, Khaled M.; Menias, Christine O.; Harvin, Howard J.; Francis, Isaac R. (July 2007). "Imaging manifestations of Meckel's diverticulum". AJR. American Journal of Roentgenology. 189 (1): 81–88. doi:10.2214/AJR.06.1257. ISSN 1546-3141. PMID 17579156.
^Sagar, Jayesh; Kumar, Vikas; Shah, D. K. (October 2006). "Meckel's diverticulum: a systematic review". Journal of the Royal Society of Medicine. 99 (10): 501–505. doi:10.1258/jrsm.99.10.501. ISSN 0141-0768. PMC 1592061. PMID 17021300.
^Yam, Julie; Ahmad, Sarah A. (2019), "Esophageal Diverticula", StatPearls, StatPearls Publishing, PMID 30422453, retrieved 2019-07-17
^O'Rourke, Ashli K.; Weinberger, Paul M.; Postma, Gregory N. (May 2012). "Killian-Jamieson diverticulum". Ear, Nose, & Throat Journal. 91 (5): 196. doi:10.1177/014556131209100507. ISSN 1942-7522. PMID 22614553.
^Feuerstein, Joseph D.; Falchuk, Kenneth R. (August 2016). "Diverticulosis and Diverticulitis". Mayo Clinic Proceedings. 91 (8): 1094–1104. doi:10.1016/j.mayocp.2016.03.012. ISSN 1942-5546. PMID 27156370.
^Stunell, H; Buckley, O; Geoghegan, T; O’Brien, J; Ward, E; Torreggiani, W (2008). "Imaging of adenomyomatosis of the gall bladder". Journal of Medical Imaging and Radiation Oncology. 52 (2): 109–117. doi:10.1111/j.1440-1673.2008.01926.x. ISSN 1754-9477. PMID 18373800.
^Oxford American handbook of urology. Albala, David M. Oxford: Oxford University Press. 2011. ISBN 9780199707720. OCLC 655896560.CS1 maint: others (link)
^"Online Textbook of Urology". www.urology-textbook.com. Retrieved 2019-07-27.
^Raymond, Steven L.; Gray, Sarah E.; Peters, Keith R.; Fatima, Javairiah (2019-06-25). "Right-sided aortic arch with aberrant left subclavian artery and Kommerell diverticulum". Journal of Vascular Surgery Cases and Innovative Techniques. 5 (3): 259–260. doi:10.1016/j.jvscit.2019.02.009. ISSN 2468-4287. PMC 6600077. PMID 31304436.
^ ab"UOTW #56 - Ultrasound of the Week". Ultrasound of the Week. 21 August 2015.
External links
Classification
D
MeSH: D004240
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Urinary bladder sinuses: a novel morphologic lesion with clinical and pathologic significance.
Mai KT, Belanger EC, Djordjevic B, Amin SM, Nguyen BN.SourceDepartment of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ontario, Canada.
Applied immunohistochemistry & molecular morphology : AIMM / official publication of the Society for Applied Immunohistochemistry.Appl Immunohistochem Mol Morphol.2012 Oct;20(5):494-500.
BACKGROUND: : We described urinary bladder sinuses (UBS) in the urinary bladder, characterized by segmental mucosal with muscularis mucosa invaginations into the submucosa (superficial UBS) and muscularis propria (deep UBS).MATERIALS: : Radical cystectomy specimens and transurethral resections of th
The RIVUR Voiding Cystourethrogram Pilot Study: Experience with Radiologic Reading Concordance.
Greenfield SP, Carpenter MA, Chesney RW, Zerin JM, Chow J.SourceDepartment of Urology, State University of New York at Buffalo School of Medicine & Biomedical Sciences, Department of Pediatric Urology, Women & Children's Hospital of Buffalo, Buffalo, New York.
The Journal of urology.J Urol.2012 Oct;188(4 Suppl):1608-12. Epub 2012 Aug 19.
PURPOSE: Two reference radiologists independently review voiding cystourethrograms for the National Institutes of Health sponsored RIVUR (Randomized Intervention for Children with Vesicoureteral Reflux) trial for children with vesicoureteral reflux. A pilot study was required from all clinical cente
