The Intramural Diverticulum and Dissecting Diverticulitis

Diverticulosis of the bowel with or without its complications is a fairly common surgical situation. Morbidity statistics range from 5% to 10% of the population, 20% of the patients having symptoms which may be ascribed to the presence of the lesion. The usual form of diverticulum respresents a protrusion of the lumen of the bowel through its retaining wall whereby the sacculation projects beyond the serosal surface. It is essentially an outpouching of the mucosa through a weakened part of any wall. Our presentation is concerned with the variant which is called the intramural and dissecting type. In this form the lumen herniates into the wall of the intestine, and then the sacculation burrows its way along the wall.

Dissecting (intramural) diverticulitis is a rodent form of diverticulum.² It begins as an extrusion of the lumen. The mucosa which originally covered the sacculation disintegrates, but remnants identify the origin