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
A diverticulum is the medical or biological term for an outpouching of a hollow (or a fluid-filled) structure in the body. Depending upon which layers of the structure are involved, they are described as being either true or false.
In medicine, the term usually implies the structure is not normally present. However, in the embryonic stage, some normal structures begin development as a diverticulum arising from another structure, such as the thyroid diverticulum that arises from the tongue.
Contents
1Anatomical
2Classification
3Human pathology
4Embryological
5See also
6Footnotes
7External links
Anatomical
Guttural pouch: A large (300-500 ml), paired, air-filled ventral diverticulum of the auditory tube found in horses and other Perissodactyla.
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.
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.
Human pathology
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.
Cardiac diverticulum: A very rare congenital malformation of the heart that is usually benign [1]
Colonic diverticula: These can become infected (see diverticulitis) and can perforate, requiring surgery
Diverticulum of Kommerell: unusual nomenclature, in that focal dilatations of a blood vessel are properly referred to as aneurysms
Duodenal and jejunal diverticul(um|a): congenital lesions, may be a source of bacterial overgrowth, may perforate and may result in abscesses
Epiphrenic diverticulum: due to dysfunction of the lower esophageal sphincter, as in achalasia
Diverticula may occur in one of the three areas of the esophagus - the pharyngoesophageal, the midesophageal area or the epiphrenic area of esophagus. Zenker's diverticulum is found three times more frequently in men than in women. It occurs posteriorly through the cricopharyngeal muscle in the midline of the neck. Usually seen in people older than 60 years of age.
Gastric diverticula - "Although usually asymptomatic, they may cause vague epigastric pain. These lesions may be confused radiologically for gastric ulcers or cancers. Endoscopically, they may be confused for paraesophageal hernias."[2]
Killian-Jamieson diverticulum
Meckel's diverticulum: a persistent portion of the omphalomesenteric duct present in 2% of the population
Rokitansky-Aschoff sinuses: in the gallbladder due to chronic cholecystitis[3]
Traction esophageal diverticulum: due to scarring from mediastinal or pulmonary tuberculosis
Urethral diverticulum: congenital in males, post-infectious in females
Zenker's diverticulum: a diverticulum of the mucosa of the pharynx affecting adults
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.
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.
Large bowel (sigmoid colon) showing multiple diverticula. Note how the diverticula appear on either side of the longitudinal muscle bundle (taenium).
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Bladder diverticula as seen on ultrasound with doppler[4]
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Bladder diverticula as seen on ultrasound[4]
Embryological
The kidneys, originally diverticula in the development of the urinary and reproductive organs
The lungs, originally diverticula forming off of the ventral foregut.
The thymus appears in the form of two flask-shape diverticula, which arise from the third branchial pouch (pharyngeal pouch) of the endoderm.
^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.
^ ab"UOTW #56 - Ultrasound of the Week". Ultrasound of the Week. 21 August 2015.
External links
Classification
D
MeSH: D004240
UpToDate Contents
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4. 憩室症と関連する分節性大腸炎 segmental colitis associated with diverticulosis
5. 患者情報：憩室症（詳細） diverticular disease beyond the basics
English Journal
A gastrointestinal stromal tumor found in perforated Meckel's diverticulum.
Miyata S1,2,3, Bliss DW4.
Surgical case reports.Surg Case Rep.2016 Dec;2(1):67. doi: 10.1186/s40792-016-0196-8. Epub 2016 Jun 29.
BACKGROUND: Meckel's diverticulum is the most common anomaly of the gastrointestinal tract. It is usually asymptomatic, but approximately 4 % present with complications such as bleeding, intestinal obstruction, and inflammation, while perforation is rare. Carcinoid or gastrointestinal stromal tumor
Detection and molecular characterization of norovirus from oysters implicated in outbreaks in the US.
Woods JW1, Calci KR2, Marchant-Tambone JG2, Burkhardt W 3rd2.
Food microbiology.Food Microbiol.2016 Oct;59:76-84. doi: 10.1016/j.fm.2016.05.009. Epub 2016 May 15.
Human noroviruses are the leading cause of non-bacterial shellfish associated gastroenteritis. Here we report on the detection and characterization of norovirus (NoV) in shellfish associated outbreaks. Requests were received from state and federal officials for technical assistance in the analysis o
BACKGROUND: In thyroid surgery, preserving the recurrent laryngeal nerve (RLN) is crucial for preventing postoperative phonatory dysfunction. Right nonrecurrent laryngeal nerves (NRLNs) are not particularly rare, and they are vulnerable to injury during surgery. This anomaly is associated with a rig
Enlarged mediastinal air cyst in a patient with bronchial diverticula localized in the left main bronchus: a case report with surgical and bronchoscopic findings
A diverticulum (plural: diverticula) is medical or biological term for an outpouching of a hollow (or a fluid-filled) structure in the body. Depending upon which layers of the structure are involved, they are described as being either true or false.