Vol. 12. Núm. 6.
Páginas 285-296 (Marzo 2016)

Actualización
Enfermedad diverticular del colon

Diverticular disease of the colon

M. Aicart-RamosabF. MesoneroabS. ParejoabB. Peñasab
Doi : https://10.1016/j.med.2016.03.002
Opciones
Resumen
Introducción

Los divertículos son un trastorno anatómico adquirido a consecuencia de la hiperpresión y al aumento de motilidad del colon, con influencia de factores ambientales como el consumo de fibra.

Manifestaciones clínicas

Con predominio en Occidente, la mayoría de los casos se mantienen asintomáticos. Sin embargo, pueden implicar un amplio abanico de patologías: enfermedad diverticular sintomática no complicada, diverticulitis, hemorragia o colitis segmentaria.

Diagnóstico

El diagnóstico en la mayoría de los cuadros se basa en la colonoscopia, salvo en la diverticulitis, donde se recurre a la TC o ecografía.

Tratamiento

El manejo es muy variado según el tipo de presentación: desde el consumo de fibra, antibióticos no absorbibles o 5-aminosalicilatos en las no complicadas y en la colitis, a la antibioterapia de amplio espectro o el tratamiento endoscópico en la diverticulitis o hemorragia. Debido a un manejo cada vez más conservador, la cirugía está siendo sustituida por el intervencionismo radiológico como tratamiento de rescate.

Palabras clave
Diverticulosis
Diverticulitis
Hemorragia diverticular
Abstract
Introduction

Diverticula are anatomic acquired disorders that appear secondary to high pressure and alteration of colon motility, influenced by environmental factors like fiber intake.

Clinical manifestations

They predominate in Western population, most of them asymptomatic. However they are implicated in several different disorders: symptomatic uncomplicated diverticular disease, diverticulitis, hemorrhage and segmental colitis.

Diagnosis

Colonosocopy is the most important diagnostic procedure, except CT or ultrasonography in case of diverticulitis.

Treatment

Treatment varies depending of the form of presentation: from fiber, nonabsorbable antibiotics or 5-aminosalicylic acid if colitis or uncomplicated disease, to broad spectrum antibiotics or endoscopic treatment if diverticulitis or hemorrhage. Because of a trend to conservative management, interventional radiology is replacing surgery as a rescue treatment.

Keywords
Diverticulosis
Diverticulitis
Diverticular hemorrhage

Identifíquese

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