Some people( approximately 1 in 5) who are randomly or systematically diagnosed with diverticulosis due to the presence of the corresponding symptom are at risk. Patients usually are in advanced age, when the digestive system by virtue of its anatomical features begins to function significantly worse. These people have various complications associated with intestinal diverticula. The group of the most frequent exacerbations of these pathologies, arising from the inflammatory process developing in them, is the perforation( rupture) of the anatomical sac. As a result, infection and internal bleeding occur, which are very dangerous for the patient's life.
Many patients are interested in how it is possible to identify the arising complications inherent in these pathological protrusions, and what is dangerous for diverticulosis at this stage of development? First of all, patients who are at risk for this pathology, that is, people over 40 who lead a passive lifestyle, should undergo regular examinations at a gastroenterologist, because pathological protrusions often occur completely asymptomatic and can only be identified by chance. Also do not forget about proper nutrition. In food, you need to consume a large amount of vegetable fiber, which contributes to the normalization of the stool and, accordingly, prevents the development of complications of diverticulosis, dangerous for the life and health of the patient.
Perforation of the diverticulum
The perforation or complete rupture of the diverticula formed on the walls of the digestive organs is the most dangerous complication caused by this disease. Pathology can develop in three directions:
- With perforation of saccular protrusion into the abdominal cavity, almost always develops diffuse peritonitis;
- In the same case, when the contents of these negative formations of the digestive organs go into the space between the leaves of the mesentery or into the retroperitoneal cavity, abscesses occur;
- If the inflammatory process developing in the intestine progresses slowly, the perforation of the diverticulum can trigger it to stick together with surrounding organs and the appearance of fistulas.
Perforation of diverticula itself is the appearance of a hole, as a result of which a fistula is formed and the mucous membrane falls into the abdominal cavity. Such a complication of diverticulosis can occur even in the case of asymptomatic disease. According to medical indications, perforation into the abdominal cavity is a direct indicator for immediate surgical intervention. If measures are not taken on time, it can lead to acute peritonitis.
Similar in its effect to perforation is the complete rupture of the diverticula, which leads to the probability of developing a malignant tumor in the digestive tract. The only difference is the scale. When ruptured, the whole body of saccular protrusion enters the abdominal cavity, which also immediately leads to an abscess or peritonitis.
Bleeding of the diverticulum
This disease is complicated by bleeding in 15% of cases, which occurs both with perforation and with damage to their neck, where a large number of vessels are adjacent. This type of exacerbation of the pathology can be insignificant, stopping on its own, or massive, when one can not do without the help of a specialist. As a result of massive bleeding, the patient develops posthemorrhagic anemia, which in 10-20% of cases ends in a fatal outcome.
If this complication occurs in the perforation of a diverticulum, it can be determined only by a large number of scarlet secretions from the rectum, as the pain syndrome and other signs are absent. Treatment of this type of pathology usually begins with intensive therapy, appointed after a sigmoidoscopy. In the event that massive bleeding caused by perforation does not stop for a long time, patients are shown scheduled surgical intervention. In order for the operation conducted in connection with this complication to give a positive dynamic, it is necessary to establish the place of localization of pathology with the help of a colonoscopy. The operation is performed by the method of segmental resection of the large intestine, and the main indications for it are unstable hemodynamics and large blood loss, provoked by the perforation of the diverticulum. If it was not possible to identify the location of the source of bleeding, during surgery, the colon is removed.
What is the risk of diverticulosis?
Speaking about the risks that arise in this disease, it is worth remembering that in most cases in the early stages it is asymptomatic. For this reason, a pathology is detected either accidentally or in later stages, when the inflammation of the protrusion or the perforation has occurred. In this situation, the only way out is urgent surgical intervention. Only with its help it is possible to prevent peritonitis, which always develops against the background of the rupture of pathological sack formation, and save the patient's life. Indications for surgery are the following exacerbations of the pathology:
- Perforation of the diverticulum into the abdominal cavity( whole or in part);
- Intestinal obstruction, which can lead to its infection due to an overabundance of stool;
- Internal bleeding in the gastrointestinal tract as a result of perforation, which do not tend to cease;
- Diverticulum complicated by an abscess.
Any of the above phenomena causes a threat to the life of the patient, therefore requires the adoption of emergency measures. But even if the disease is discovered by chance and does not have any specific signs, its presence in the abdominal cavity creates a threat that at any time its inflammation can start, which can easily provoke the perforation of the pathological protrusion or its complete rupture. In order to avoid these exacerbations, people at risk for developing this pathology should reconsider their lifestyle, making it more active, and adjusting their diet and diet.