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Diverticular Disease of the Colon

Diverticular Disease of the Colon

Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...

Inflammatory Bowel Disease V: Surgical Management

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...

Chronic Bowel Disorders: Introduction

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...

Inflammatory Bowel Disease II: Crohn's Disease

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...

Inflammatory Bowel Disease I: Ulcerative Colitis

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...

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Related Experiment Videos

Long-term steroids and an extensive diverticular abscess.

Eleanor Jane H Turner¹, Syed Arsalan Raza

¹Surgery Department, Epsom General Hospital, Epsom, UK. ejhturner@yahoo.com

BMJ Case Reports

|July 5, 2012

Summary

Long-term steroid use for asthma can mask serious conditions like colon diverticular abscesses. This case highlights how corticosteroids can complicate diagnosis and treatment of such infections.

Area of Science:

Gastroenterology
Pulmonology
Pharmacology

Background:

Corticosteroid therapy is widely used for chronic asthma management.
Prolonged corticosteroid use can lead to various systemic side effects.
Diverticular disease is a common condition affecting the colon.

Observation:

A 70-year-old female patient with a 40-year history of asthma treated with corticosteroids presented with a subcutaneous abscess.
The abscess was found to be related to diverticular disease of the colon.
The patient's long-term steroid use potentially masked the typical signs of the diverticular abscess.

Findings:

This case demonstrates the potential for corticosteroids to obscure underlying pathologies.
Subcutaneous abscess formation secondary to colonic diverticular disease is a potential complication in patients on long-term corticosteroid therapy.

Related Experiment Videos

The diagnosis of diverticular abscess was delayed due to masked symptoms.

Implications:

Physicians should maintain a high index of suspicion for serious infections in patients on long-term corticosteroid therapy, even with atypical presentations.
Awareness of corticosteroid-induced immunosuppression is crucial for timely diagnosis and management of complications from conditions like diverticular disease.
This case underscores the importance of considering iatrogenic causes when evaluating complex patient presentations.