Diverticulosis refers to multiple pouching of the intestinal wall, as opposed to isolated phenomena, such as congenital or traction diverticula.Anatomy.-Each pouch is a hernia of the mucosa through the muscular wall of the bowel, at a point at which a weakness exists. The essential anatomy is the same whether the pouching is in the duodenum, jejunum, or colon, though the relation to the circumference of the bowel differs. The muscularis mucosie accompanies the mucous membrane, and sometimes hypertrophies, especially in diverticula of the jejunum.The weak areas through which the mucous membrane is extruded are usually provided by the passage of the blood vessels through the circular muscle coat. Hence, in early cases, diverticula of the sigmoid are often seen in two regularly disposed rows, set at the edge of the two longitudinal txenia, on either side of the mesentery. Each corresponds in situation to a tenia epiploica, which receives a branch from the vessel concerned immediately before the latter disappears through the muscularis.Differences in the situation of pouches in the ascending colon and cecum in relation to the circumference of the bowel are due to differences in the arrangement of the blood vessels. The pouches here also differ from those of the left side of the colon in that they may be single, or at least very sparse; they are more liable to become acutely inflamed; and may develop at an earlier age.
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