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Diverticular Disease of the Colon. In: Kelly, K.A.; Sarr, M.G.; Hinder, R.A., eds. Mayo Clinic Gastrointestinal Surgery. St. Louis, MO: Elsevier Science. 2004. p. 489-505.

A colonic diverticulum is a sac of mucosa protruding through the muscle wall of the colon; inflammation associated with diverticula is called diverticulitis. Complicated diverticulitis refers to the development of abscess, fistula, obstruction, bleeding, and perforation; simple diverticulitis describes the presence of diverticulitis in the absence of these complications. This chapter on diverticular disease of the colon is from a book that focuses on the major diseases treated by gastrointestinal surgeons, from the esophagus to the anal canal. The presentation has a definite clinical orientation and a major emphasis on practical applications as they are applied at the Mayo Clinic. The authors of this chapter review terminology, pathology and pathophysiology, clinical presentation, diagnosis and imaging, medical therapy and indications for operation, conduct of operation (emergency and elective laparotomy), outcomes and long-term follow-up, and diverticular bleeding. The chapter is illustrated with line drawings. 11 figures. 1 table. 95 references.

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Mayo Clinic Gastrointestinal Surgery. St. Louis, MO: Elsevier Science. 2004. 1020 p.

This book focuses on the major diseases treated by gastrointestinal surgeons, from the esophagus to the anal canal. The presentation has a definite clinical orientation and a major emphasis on practical applications as they are applied at the Mayo Clinic. Sections on etiology, pathophysiology, pathology, and diagnosis are also included by are purposely not the emphasis of the chapters. The book offers 49 chapters: the experience of being a Mayo Clinic surgeon; gastroesophageal reflux disease (GERD) and esophageal hiatal hernia; achalasia and other esophageal motility disorders; epiphrenic esophageal diverticula; cancer of the esophagus; gastric adenocarcinoma, primary gastric lymphoma; peptic ulcer; disorders of gastrointestinal motility and emptying after gastric operations; morbid obesity; hepatocellular carcinoma and intrahepatic cholangiocarcinoma; hepatic metastases from extrahepatic cancers; benign tumors and cysts of the liver; liver diseases necessitating liver transplantation; biliary stone disease; benign biliary strictures; cancer of the gallbladder; pancreatic and periampullary carcinoma; islet cell tumors; acute and chronic pancreatitis; pancreas transplantation after complications of diabetes mellitus; cystic tumors of the pancreas; thrombocytopenia and other hematologic disorders; malignant tumors of the small intestine; villous tumors of the duodenum; small intestinal diverticula; Crohn's disease; small bowel obstruction; acute mesenteric ischemia; acute mesenteric venous thrombosis; chronic mesenteric ischemia; visceral artery aneurysms; colonic motor disorders (constipation); diverticular disease of the colon; colon cancer; ischemic colitis; appendicitis; chronic ulcerative colitis; colonic volvulus; familial adenomatous polyposis; cancer of the rectum; common anorectal problems; rectal prolapse and solitary rectal ulcer syndrome; abdominal trauma; unclosable abdomen and the dehisced wound; ventral and incisional hernias; open repair of inguinal hernia; endoscopic inguinal hernia repair; and common pediatric gastrointestinal disorders. Each chapter is illustrated with line drawings, black and white photographs, and some color plates. References are provided with each chapter and a detailed subject index concludes the text.

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Small Intestinal Diverticula. In: Kelly, K.A.; Sarr, M.G.; Hinder, R.A., eds. Mayo Clinic Gastrointestinal Surgery. St. Louis, MO: Elsevier Science. 2004. p. 397-408.

Diverticula are found throughout the small intestine. However, because of their relative rarity and the infrequency with which they cause complications, they have historically been viewed as anatomical curiosities rather than life-threatening disorders. This chapter on small intestine diverticula is from a book that focuses on the major diseases treated by gastrointestinal surgeons, from the esophagus to the anal canal. The presentation has a definite clinical orientation and a major emphasis on practical applications as they are applied at the Mayo Clinic. The authors of this chapter note that complications of small intestine diverticula can indeed occur, and when they do, serious morbidity and even mortality (death) can result. The authors cover duodenal diverticula, jejunoileal diverticula, Meckel's diverticulum. For each type, the authors discuss location, incidence, cause, symptoms and signs, diagnosis, and treatment. The chapter is illustrated with line drawings and full-color photographs. 8 figures. 83 references.

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Acute Bleeding from Diverticulosis and Ischemic Colitis. In: Chung, P. and Kim, K.E. Acute Gastrointestinal Bleeding: Diagnosis and Treatment. Totowa, NJ: Humana Press. 2003. p. 163-174.

Lower gastrointestinal (GI) bleeding is a common medical problem in the United States. Two common causes of such bleeding are diverticulosis and ischemic colitis. This chapter reviews the pathogenesis, diagnosis, and management of bleeding associated with these two conditions. The chapter is from a textbook in which leading experts in the fields of gastroenterology, surgery, and radiology comprehensively review the pathophysiology, diagnosis, management, and treatment of acute bleeding disorders of the GI tract. The authors of this chapter note that acute diverticular bleeding is the most common cause of lower GI bleeding. Most patients are otherwise asymptomatic at presentation, and bleeding ceases spontaneously 70 to 80 percent of the time. Ischemic colitis is the most common form of intestinal ischemic injury, most often occurring in the left side of the colon. Colonoscopy is the diagnostic procedure of choice since it allows direct visualization of the mucosa and tissue sampling. Management is usually merely supportive, consisting of bowel rest and intravenous fluid and antibiotics, with most patients recovering in 24 to 48 hours. 2 figures. 39 references.

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Bladder, Urethra, Renal Pelvis, and Ureter. In: MacLennan, G.T.; Resnick, M.I.; Bostwick, D.G.. Pathology for Urologists. New York, NY: Elsevier Science, Inc. 2003. p. 33-79.

The renal pelvis, ureter, bladder, and urethra are muscular structures, are all lined by urothelium, and are all involved in the collection and expulsion of urine. This chapter on the bladder, urethra, renal pelvis, and ureter is from a pathology textbook that explores the full range of urology, including congenital, hereditary, inflammatory, degenerative, and benign and malignant neoplastic disorders found in the urogenital system. The chapter includes full-color photographs of gross and microscopic pathologic specimens, representing virtually all of the common and rare entities seen in practice. After an introductory section on anatomy and histology, the chapter covers congenital anomalies of the bladder, inflammatory and reactive conditions, acute and chronic cystitis, interstitial cystitis, postoperative spindle cell nodule, urothelial hyperplasia, reactive changes in the urothelium, squamous metaplasia, nephrogenic metaplasia, miscellaneous benign lesions, urothelial neoplasms, papilloma, adenocarcinoma, leiomyoma, hemangioma, neurofibroma, granular cell tumor, bladder sarcomas, hematopoietic malignancies, melanoma, pheochromocytoma, congenital urethral polyp, prostatic-type urethral polyp, urethral diverticulum, urethral caruncle, nephrogenic metaplasia, amyloidosis, malakoplakia, condyloma acuminata, congenital malformations of the renal pelvis and ureter, squamous metaplasia, benign epithelial neoplasms, carcinoma of the ureter and renal pelvis, and soft tissue tumors. Each photograph is accompanied by a descriptive text section. The text also includes explanations of the most current neoplasm classification and staging systems. 130 figures. 2 tables.

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Diverticular Disease of the Colon. In: Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 1843-1863.

A diverticulum is a sac-like protrusion of the colonic wall. The spectrum of diverticular disease encompasses diverticulosis, diverticulitis, and diverticular bleeding. This chapter on diverticular diseases of the colon is from a comprehensive gastroenterology textbook that provides an encyclopedic discussion of virtually all the disease states encountered in a gastroenterology practice. The authors of this chapter initially discuss the common epidemiology, etiology (cause), pathogenesis, pathophysiology, and natural history of diverticular diseases of the colon. A detailed discussion of the clinical presentation, diagnosis, and treatment follows, concentrating on the specific diverticular diseases and addressing special situations dictating a more individualized approach. The chapter is illustrated with black-and-white reproductions of imaging studies and drawings. 19 figures. 2 tables. 117 references.

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Diverticular Disease. In: PDxMD. PDxMD Gastroenterology. St. Louis, MO: Elsevier Science. 2003. p. 167-191.

Diverticulosis is a disorder of the digestive tract, consisting of sac-like outpouchings of mucosa and submucosa through the muscular layer. Diverticular disease encompasses all aspects and effects of the condition, including diverticulitis (inflammation of the diverticula). This chapter on diverticular disease is from a book on gastroenterology that offers concise, action-oriented recommendations for primary care medicine. The chapter covers summary information and background on the condition, and comprehensive information on diagnosis, treatment, outcomes, and prevention. Specific topics covered include the ICD9 code, urgent action, synonyms, cardinal features, causes (etiology), epidemiology, differential diagnosis, signs and symptoms, associated disorders, investigation of the patient, appropriate referrals and consultations, diagnostic considerations, clinical tips, treatment options, patient management issues, drug therapies, prognosis, complications, and how to prevent recurrence. The information is provided in outline and bulleted format for ease of accessibility. The final section of the chapter offers resources, including related associations, key references, and the answers to frequently asked questions (FAQs). 46 references.

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Diverticular Diseases. In: Bonci, L. American Dietetic Association Guide to Better Digestion. Hoboken, NJ: John Wiley and Sons, Inc. 2003. p. 114-126.

Coping with a gastrointestinal disorder, whether it is irritable bowel syndrome (IBS), gas (flatulence), constipation, heartburn, or another condition, can be embarrassing and debilitating. While medical treatments and prescriptions can offer relief, one of the most important ways patients can help themselves is in their dietary choices. This chapter on diverticular diseases is from a book that describes how patients can self-manage their digestive disorders through dietary choices. Diverticular disease is characterized by the presence of small, bulging, abnormal pouches in the intestinal wall. In this chapter, the author defines diverticular diseases (diverticulosis and diverticulitis), including their symptoms, then discusses the diagnostic tests that are used to confirm diverticular problems, treatment options, the use of nutritional supplements (notably dietary fiber), the impact of diet on diverticular symptoms, foods to choose for diverticulosis, and foods to choose for diverticulitis. The author notes that the treatment for diverticular disease is a combination of specialized diet to increase fecal mass, medications, surgery, stress management, and exercise. Diverticulitis is an acute disease, which means that patients may need to make temporary changes in eating to allow their bodies a chance to heal, but once improvement is seen, patients should go right back on a maintenance eating plan to keep the gut healthy and to decrease the risk of future diverticula forming. 4 figures.

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Diverticulosis and Diverticulitis. Journal of Wound, Ostomy, and Continence Society. 31(2): 75-82. March-April 2004.

This article for ostomy nurses discusses diverticulosis and diverticulitis, common disorders in modern society that represent different places on the spectrum of diverticular disease. Often called a problem of western civilization, diverticular disease is rare in developing countries. The author provides an overview of the epidemiology of diverticular disease, risk factors, and clinical presentation in varying phases. Differential diagnostic testing and comprehensive management from the medical, surgical, and wound, ostomy, and continence nursing perspectives are also addressed. Nurses play a key role in supporting people with diverticular disease and in referring them for appropriate assessment, treatment, and support. 3 tables. 72 references.

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Esophageal Motility Disorders. In: Katzka, D.A. and Metz, D.C., eds. Esophagus and Stomach. Orlando, FL: Mosby, Inc. 2003. p. 49-67.

Motility disorders of the esophagus encompass a wide spectrum of entities characterized by symptoms suspected of being esophageal in origin (e.g., chest pain, painful swallowing) and abnormal esophageal motility patterns. This chapter on esophageal motility disorders is from a textbook on the esophagus and stomach in which the authors focus on differential diagnosis, pitfalls, and evidence-based management approaches. The chapter covers anatomy, the physiology of swallowing, oropharyngeal dysphagia, globus sensation, Zenker's diverticulum, and primary esophageal motility disorders. For each condition, the authors review symptoms, diagnosis, and patient care management (treatment options). The chapter begins with a chapter outline, includes extensive tables and illustrations, and concludes with a list of recommended readings. 6 figures. 1 table. 10 references.

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