Etiopathogenetic Mechanisms in Diverticular Disease of the Colon

Camilleri, Michael; Sandler, Robert S.; Peery, Anne F.

doi:10.1016/j.jcmgh.2019.07.007

Cited by 40 publications

(60 citation statements)

References 146 publications

(112 reference statements)

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“…This individual's diverticula were mostly localized to the ascending and transverse colon, which is consistent with diverticulosis in Asian and African populations [4,5]. Diverticular disease has an estimated genetic contribution of 40% to 53% [10]. The presence of extensive diverticula in this individual could be linked to a genetic predisposition for diverticulosis exacerbated by additional lifestyle risk factors [10].…”

Section: Discussionsupporting

confidence: 69%

“…Diverticular disease has an estimated genetic contribution of 40% to 53% [10]. The presence of extensive diverticula in this individual could be linked to a genetic predisposition for diverticulosis exacerbated by additional lifestyle risk factors [10]. Specifically, collagen cross-linking defects are speculated to play a role in diverticulosis cases with high diverticula quantity [2,8].…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, collagen cross-linking defects are speculated to play a role in diverticulosis cases with high diverticula quantity [2,8]. Ehlers-Danlos (type IV), Marfan, Coffin-Lowry, and Williams syndromes are associated with both vascular disease and relatively severe diverticulosis [2,10,11]. Increased expression of matrix metalloproteinase-1 has been implicated in cases of diverticulosis without diverticulitis [10].…”

Section: Discussionmentioning

confidence: 99%

“…Ehlers-Danlos (type IV), Marfan, Coffin-Lowry, and Williams syndromes are associated with both vascular disease and relatively severe diverticulosis [2,10,11]. Increased expression of matrix metalloproteinase-1 has been implicated in cases of diverticulosis without diverticulitis [10]. Patients with pancolonic diverticula may warrant genetic evaluation to rule-out collagen disorders.…”

Section: Discussionmentioning

confidence: 99%

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Acquired Diverticulosis of the Entire Colon in a Cadaver

Lucas

Roberts

Gunderson

et al. 2020

Cureus

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Diverticulosis involving the entire colon is rare in Western society. During a routine dissection of a 74-year-old Caucasian female cadaver, who died from vascular disease complications, diverticula were observed in the ascending, transverse, and descending colon. A total of 413 diverticula were manually counted. The majority of diverticula arose from the right and transverse colon, which is atypical of the disease in Western society. Histological examination of sections from sample diverticula reveals morphology consistent with pseudodiverticula, suggestive of acquired disease. Pancolonic diverticulosis may be associated with systemic diseases such as collagen disorders, vascular complications, and increased risk of recurrent diverticulitis. This case is an example of a rare manifestation of diverticular disease that is important for clinicians to recognize when evaluating and treating patients with gastrointestinal symptoms.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acquired Diverticulosis of the Entire Colon in a Cadaver

Lucas

Roberts

Gunderson

et al. 2020

Cureus

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“…Genetic connective tissue disorders like Ehlers-Danlos and Marfans syndrome have been linked to the development of diverticulosis in young age [34,35]. Some studies indicated that genes involved in immunity, extracellular matrix, cell adhesion, membrane transport and intestinal motility may be related to diverticular disease [36][37][38]. However, the exact mechanisms remain to be shown.…”

Section: What Are the Risk Factors For Diverticulosis Diverticulitismentioning

confidence: 99%

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

188

177

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Aim The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than 90% agreement was considered a consensus. The final phrasing of the statements with < 90% agreement was discussed in a consensus meeting at the ESCP annual meeting in Vienna in September 2019. Thereafter, the first and the last author drafted the final text of the guideline and circulated it for final approval and for a third and final online voting of rephrased statements. Results This guideline contains 38 evidence based consensus statements on the management of diverticular disease. Conclusion This international, multidisciplinary guideline provides an up to date summary of the current knowledge of the management of diverticular disease as a guidance for clinicians and patients.

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