What are diverticula and how are they differentiated from pseudodiverticula (false diverticula)?

Updated: Aug 06, 2019
  • Author: Elie M Ghoulam, MD, MS; Chief Editor: BS Anand, MD  more...
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A diverticulum is a mucosal protrusion through the intestinal wall that occurs along natural areas of weakness. In the large intestine, there is only one complete muscular layer, the inner circular layer, whereas the small intestine and rectum have two muscular layers. The outer longitudinal muscular layer of the large intestine is arranged in three ribbons, the taeniae coli. Diverticula typically occur at sites where the vasa recta, or nutrient vessels in the wall of the colon, penetrate the circular layer, between the taeniae. [11]

True diverticula contain all layers of the gastrointestinal wall (mucosa, muscularis propria, and adventitia) (eg, Meckel diverticulum). False diverticula, or pseudo-diverticula do not contain the muscular layers or adventitia, only involving the submucosa and mucosa. Diverticula can occur anywhere in the gastrointestinal tract but are usually observed in the colon. As noted earlier, the sigmoid colon has the highest intraluminal pressures and is the most commonly affected.

Diverticula found in the left colon (predominantly in the sigmoid) are usually false diverticula, and they are often seen in Western populations. Right-sided and cecal diverticula, however, are more frequently true diverticula; these are usually seen in people of Asian descent. Cecal diverticula are generally rare compared to those found in the left colon. [14]

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