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What Causes a Diverticulum?

Reviewed on 6/19/2020

What Is a Diverticulum?

Pictured are different ways diverticula may appear in the intestine -- the black line shows a fistula, or abnormal connection between parts of the bowel.
Pictured are different ways diverticula may appear in the intestine -- the black line shows a fistula, or abnormal connection between parts of the bowel.

A diverticulum is an abnormal sac or pouch that forms in the wall of a major organ in the body. 

Types of diverticulum include: 

  • Small intestine (Meckel's diverticulum) 
  • Esophageal diverticula       
    • Pharynx  (Zenker's diverticulum)  
    • Midesophageal
    • Epiphrenic (lower esophageal sphincter)
    • Killian-Jamieson diverticulum 
  • Colon (diverticulitis/diverticulosis
  • Duodenal and jejunal diverticulum (congenital lesions) 
  • Gallbladder (Rokitansky-Aschoff sinuses)
  • Kidney (calyceal diverticulum)
  • Bladder  
  • Urethra (tends to occur following infectious in females, and are congenital in males)
  • Cardiac (rare malformation of the heart present at birth that is usually benign
  • Aorta (diverticulum of Kommerell)

What Are Symptoms of a Diverticulum?

Symptoms of a diverticulum vary depending on the organ involved. Symptoms of some common types of diverticula include:

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What Causes a Diverticulum?

Causes for diverticulum vary. 

Causes of diverticulum in the colon (diverticulitis/diverticulosis) include:

  • Increased pressure on the intestinal wall from inside the intestine due to 
    • Age
    • Hard stools
    • Frequent straining during bowel movements
    • Diets low in fiber 
  • Meckel’s diverticulum in the small intestine is caused by a bulge left over from the umbilical cord. It is present from birth. 

Causes of diverticulum in the urethra include:

Diverticulum in the pharynx and esophagus (Zenker's diverticulum) involve malfunctioning of the cricopharyngeal muscle and weakness of the esophagus wall caused by:

How Is a Diverticulum Diagnosed?

A medical history and physical exam can help diagnose diverticulum. In addition, tests for various diverticulum depend on the organ suspected and may include:

What Is the Treatment for a Diverticulum?

Treatment for diverticulitis/diverticulosis includes:

Treatment for Meckel's diverticulum includes:

  • Surgical removal if it is causing symptoms

Treatment for urethral diverticulum includes:

  • Applying pressure with the fingers on the suburethral mass after urinating
  • Periodic needle aspiration 
  • Antibiotic prophylaxis for recurrent UTIs
  • Surgery

Treatment for diverticulum in the pharynx and esophagus (Zenker's diverticulum) includes: 

  • Surgery
  • Non-surgical endoscopic technique

What Are Complications of a Diverticulum?

Complications of a diverticulum include:

  • Recurrent symptoms
  • Need for additional surgery 
  • Bowel perforation (diverticulitis/diverticulosis)
  • Peritonitis - serious infection of the abdominal cavity (diverticulitis/diverticulosis)
  • Blockage or obstruction of the intestine (diverticulitis/diverticulosis)
  • Bleeding in the intestine (diverticulitis/diverticulosis)
  • Abscess (pocket of infection) 
  • Fistula (abnormal connection between one organ and another organ – often causes a severe infection)
  • Kidney stones (urethral diverticulum)
  • Urinary tract infections (UTIs caused by urethral diverticulum)

How Do You Prevent A Diverticulum?

The main way to prevent diverticulosis and diverticulitis (diverticulum in the colon) is by consuming a high fiber diet. 

Some cases of urethral diverticulum in women may be prevented by properly treating urinary tract infections (UTIs) if they develop.

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Reviewed on 6/19/2020
References
Medscape Medical Reference

UpToDate.com
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