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Acute Diverticulitis Pathophysiology

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The discussion about the pathophysiology of acute diverticulitis starts with how diverticulosis is acquired. It is believed that it may be caused by increased intraluminal pressure due to low fiber diet and chronic constipation, or connective tissue disorders like Marfan's Syndrome and Ehlers-Danlos Syndrome (Mills & Stappenbeck, 2013). These conditions can lead to herniation that ranges from five to ten millimeters on one or more of the colonic walls (Graham, 2016). Based on how many colonic walls are involved, diverticulosis is divided into two types. It is called true diverticulosis if the herniation involves the entire colonic wall, or false diverticulosis if it only involves submucosa and mucosa walls (Van Buren & …show more content…
In a few cases, acute diverticulitis occurs. The process is described by Van Buren and Fisher (2017) as follows: fecal matter will fill the diverticulosis and provide an environment that facilitates bacterial overgrowth. This results in irritations to the colonic wall, which can cause inflammation or microperforations. These give access for bacteria from gastrointestinal GI tract invade the colonic wall, resulting in infection with or without abscess formation.
Acute diverticulitis can be complicated or uncomplicated. Uncomplicated diverticulitis is characterized by local infection and inflammations. If the localized infection or abscess infiltrates into adjacent organs or viscera, or causes obstruction, it is considered complicated diverticulitis. The typical bacteria involved are anaerobes such as bacteroides, peptostreptococcus, clostridium, and fusobacterium and gram-negative rods such as escherichia coli (E.coli) (Graham, 2016).
Complicated diverticulitis can be staged, based on the Hinchey's classification: “Stage 1 is small, confined pericolic or mesenteric abscesses; Stage 2 is larger abscesses, extending to the pelvis; Stage 3 is perforated diverticulitis and purulent peritonitis; and Stage 4 refers to free perforation with fecal contamination of the peritoneal cavity” (Graham, …show more content…
R., Lee, S., Kaiser, A., Boushey, R., Buie, D., & Rafferty, J. F. (2014). Practice Parameters for the Treatment of Sigmoid Diverticulitis. Diseases of the Colon & Rectum, 57, 284-293. Retrieved from https://www.fascrs.org/sites/default/files/downloads/publication/practice_parameters_for_the_treatment_of_sigmoid.2.pdfGraham, A. (2016). Diverticulitis. In J. E. Tintinalli, S. J. Stephan, J. O. Ma, D. M. Yealy, G. D. Meckler, G. D. Meckler, & D. M. Cline (Eds.), Tintinalli’s Emergency Medicine: A Comprehensive Study Guide (8 ed. []. Retrieved from http://mhmedical.com/content.aspx?aid=1121505921McQuaid, K. R. (2017). Gastrointestinal Disorders. In M. A. Papadakis, S. J. MePhee, & M. W. Rabow (Eds.), Current Medical Diagnosis & Treatment. []. http://dx.doi.org/http://mhmedical.com/content.aspx?aid=1132700935Mills, J. C., & Stappenbeck, T. S. (2013). Gastrointestinal Disease. In G. D. Hammer & S. J. McPhee (Eds.), Pathophysiology of Disease: An Introduction to Clinical Medicine (7 ed. []. Retrieved from http://mhmedical.com/content.aspx?aid=1100860727Pancholi, P., & Balada-Llasat, J. (2015). Inpatient Antimicrobial Susceptibility Report 2015. Retrieved January 16, 2017, from https://onesource.osumc.edu/departments/Epidemiology/Documents/BugsAndDrugs/Main%20Ross%20antibiogram.pdf#search=antibiotic%20antibiogramStollman, N., Smalley, W., Hirano, I., Adams, M. A., Dorn, S. D., Dudley-Brown, S. L., ... Yang, Y. (2015). American

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