Diverticula

Saccular protrusion of the mucous membrane and submucosal layer into defects in the muscular lining of the digestive tract. Diverticula can be congenital (their wall consists of all layers of the intestine; they are located on the antimesenteric edge of the intestine) and acquired. Acquired diverticula occur due to inflammatory changes in the wall of the organ and surrounding tissues; can be pulsational (based on an increase in pressure in the lumen of the organ with subsequent protrusion of the mucous membrane) and traction (the inflammatory peri-process draws in the wall of the organ).

Esophageal diverticula are localized in the cervical region (70%), at the level of the tracheal bifurcation (20%) and above the diaphragm (10%). Bifurcation diverticula are classified as tractional, while the rest are classified as pulsational. To diagnose diverticula, X-ray examination with contrast is often used; endoscopic examination must be used according to indications and with caution (perforation of the diverticulum, especially the cervical one, is possible).

Cervical diverticulum occurs as a result of weakness of the posterior wall of the pharyngoesophageal junction on one side and dyskinesia of the cricopharyngeal muscle on the other. As a result of premature contraction of the upper sphincter, increased pressure occurs and the mucous membrane of Killian's triangle bulges, forming a diverticulum.

The main symptoms are dysphagia, a feeling of pressure and fullness in the neck, regurgitation of food, cough, change in voice. Treatment is surgical.

Bifurcation diverticulum is often of a traction nature. May be complicated by diverticulitis, perforation, pneumonia. Treatment is surgical.

Epiphrenic diverticulum occurs above the esophageal hiatus of the diaphragm. Manifested by pain and dysphagia. Treatment for large sizes is surgical.

Gastric diverticula are rare, most often on the posterior wall. They appear with diverticulitis. Diagnostics - X-ray, endoscopy. Surgical treatment is indicated.

Diverticula of the duodenum can be complicated by diverticulitis, cholangitis, pancreatitis, and jaundice. Diagnostics - X-ray, endoscopy. Treatment is often conservative, and if ineffective, surgical.

Meckel's diverticulum is located in the ileum. It may be asymptomatic, complicated by bleeding, diverticulitis, or obstruction. Treatment is surgical excision.