Definition

blind pouches that protrude from the gastrointestinal wall and communicate with the lumen

• True diverticulum: a type of diverticulum that affects all layers of the intestinal wall.

  • Rare (except Meckel diverticulum )

  • Typically congenital

  • Most commonly occur in the cecum

  • Occur less commonly in the colon

• False diverticulum or pseudodiverticulum: type of diverticulum that involves only the mucosa and submucosa and does not contain muscular layer or adventitia.

  • Most common type of gastrointestinal diverticula

  • Typically acquired

  • Localized particularly in the sigmoid colon

the presence of multiple colonic diverticula without evidence of infection

• In the US, ∼ 50% of individuals > 60 years have diverticulosis

• More common in high-income countries due to the higher prevalence of a high-fat, low-fiber diet

• Caused mainly by lifestyle and environmental factors

  • Diet (low-fiber, rich in fat and red meat)

  • Obesity

  • Low physical activity

  • Increasing age

  • Smoking

• Other causes: genetic factors

  • Connective tissue disorders (e.g., Marfan syndrome, Ehler-Danlos syndrome) [1][3]

  • Autosomal dominant polycystic kidney disease

The formation of diverticula is considered multifactorial.

• Increased intraluminal pressure, e.g., due to chronic constipation

• Weakness of the intestinal wall

  • Age-related loss of elasticity of the connective tissue

  • Physiological gaps in the intestinal wall, which occur where blood vessels penetrate, predispose to protrusion and herniation of intestinal mucosa and submucosa.