Diverticulitis: Pathophysiology
Pathogenesis of diverticulitis remains unclear. Fecal material or undigested food particles may collect in a diverticulum causing obstruction.
Mucous secretion and overgrowth of normal colonic bacteria causes further distension of the diverticula. Vascular compromise and subsequent microperforation or macroperforation then ensue.
Alternatively, some believe that increased intraluminal pressure or inspissated food particles cause erosion of the diverticular wall, resulting in inflammation, focal necrosis, and perforation. The disease is frequently mild when pericolic fat and mesentery wall off a small perforation. However, larger perforations and more extensive disease lead to abscess formation and, rarely, intestinal rupture or peritonitis.
Mucous secretion and overgrowth of normal colonic bacteria causes further distension of the diverticula. Vascular compromise and subsequent microperforation or macroperforation then ensue.
Alternatively, some believe that increased intraluminal pressure or inspissated food particles cause erosion of the diverticular wall, resulting in inflammation, focal necrosis, and perforation. The disease is frequently mild when pericolic fat and mesentery wall off a small perforation. However, larger perforations and more extensive disease lead to abscess formation and, rarely, intestinal rupture or peritonitis.