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a herniation through the muscular wall of a tubular organ (especially the colon)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/11/20 13:31:32」(JST)

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A diverticulum (plural: diverticula) 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.

Anatomical

Guttural pouch: A large (300-500 ml), paired, air-filled ventral diverticulum of the auditory tube found in horses and other Perissodactyla.

Classification

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.
False diverticula do not involve muscular layers or adventitia. False diverticula, in the GI tract for instance, involve only the submucosa and mucosa.

Pathological

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

Large bowel (sigmoid colon) showing multiple diverticula. Note how the diverticula appear on either side of the longitudinal muscle bundle (taenium).
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 time 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 diverticulae - "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
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.

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.

Footnotes

^ Vazquez-Jimenez, Dr. Jaime (2003). "Cardiac diverticulum". Orphanet Encyclopedia. http://www.orpha.net/data/patho/Pro/en/CardiacDiverticulum-FRenPro3437.pdf. Retrieved 2008-01-14.
^ Velanovich, V. (1994). "Gastric diverticulum". Surgical Endoscopy 8 (11): 1338–1339. doi:10.1007/BF00188296. PMID 7831610. edit

UpToDate Contents

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1. ツェンカー憩室 zenkers diverticulum
2. 結腸憩室症の臨床症状および診断 clinical manifestations and diagnosis of colonic diverticular disease
3. 小腸憩室 small bowel diverticula
4. 女性における尿道憩室 urethral diverticulum in women
5. 急性憩室炎の治療 treatment of acute diverticulitis

English Journal

Pulsatile tinnitus in perimenopausal period.

Hou ZQ, Han DY.SourceDepartment of Otolaryngology Head and Neck Surgery , Chinese PLA General Hospital , Beijing.
Acta oto-laryngologica.Acta Otolaryngol.2011 Aug;131(8):896-904. Epub 2011 Apr 26.
Abstract Sigmoid sinus diverticulum-induced pulsatile tinnitus is a rare medical problem. Here we report a case where pulsatile tinnitus occurred in the perimenopause with evidence of sigmoid sinus diverticulum. The tinnitus disappeared with the restoration of hearing after surgery. While diagnosis
PMID 21521010

Enterolith ileus: liberated large jejunal diverticulum enterolith causing small bowel obstruction in the setting of jejunal diverticulitis.

Garnet DJ, Scalcione LR, Barkan A, Katz DS.SourceDepartment of Radiology.
The British journal of radiology.Br J Radiol.2011 Aug;84(1004):e154-7.
We present an 80-year-old man with multiple medical problems, and acute abdominal pain with feculent emesis. An unenhanced CT examination of the abdomen and pelvis demonstrated jejunal diverticulitis and findings of high-grade small bowel obstruction caused by a large enterolith. Enterolith ileus ha
PMID 21750131