Symptomatic diverticular stenosis of the colon is a consequence of diverticulitis, inflammation of the diverticula of the colon, which in the elderly can lead to a narrowing of the lumen, preventing the passage of stool. “Sometimes – explains the professor Giuseppe Pappalardo, professor of general surgery at the La Sapienza University of Rome – in cases of severe inflammation, medical therapy is used, but then often resolved with surgery. This is an operation that involves resection of the compromised part. After the surgery, the patient remains in the hospital for at least ten days. These are interventions of some importance – explained the doctor – but frequent “.
What are diverticula
Diverticula are sack-like herniations that affect the mucosa and submucosa of the intestinal wall and are more frequently located in the left colon and in particular in the sigmoid colon. Diverticular disease, explains Sice, the Italian Society of Endoscopic Surgery and New Technologies, “involves approximately 300,000 hospitalizations per year in the United States, with 1.5 million days of hospital treatment. In fact, this disease is the third most gastrointestinal disease. common requiring hospitalization and the primary indication for elective colon resection “.
Who is most affected by it
Colon diverticulosis is reported more in Western countries and mainly affects elderly subjects and is equally distributed in both sexes. The incidence increases with age, starting from 10% of cases under the age of 40, up to 25% at 60 years up to 50% in subjects over 80 years of age.
The course of the disease
“The unfavorable clinical evolution of diverticulosis – explains Sice – occurs when inflammation develops inside the diverticula. The clinical picture is generically called diverticulitis and therefore expresses the presence of uncomplicated diverticular disease. form occurs in 10 to 25% of cases of diverticulosis and after the first episode it may reappear, despite therapy, in 25% within the first 5 years. This occurrence, which takes the name of relapse, varies from 7 to 42%. The risk of further relapse after the first hospitalization is 3%, at least 50% of such relapses occur within the first year and 90% within 5 years.
The complications: when surgery is needed
The complications described were reported in a total of 5% of subjects with diverticulosis followed for 10 to 30 years. In the United Kingdom, the incidence of perforation is 4 cases per 100,000 people, quantifying approximately 2000 cases per year “. Diverticular disease can be complicated in various forms and involve urgent surgery.” Among the manifestations – explains Sice – there is intestinal obstruction in the presence of a narrowing of the intestinal lumen (stenosis) induced by the inflammation present in the diverticula and in the surrounding intestinal lumen “.
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