Case Study

Lower Gastrointestinal Bleeding secondary to

Diverticulitis

Group 37

Abdon, Anna Francesca Barbon, Aurelle Janine

Alvarez, Shelemiah Ann Besana, Khristian
Amarillento, Aira Blanz Bolotaolo, Arvin Keith
Aquino, Terence James Bragas, Kevin Cloyd
Bagarinao, Rey Albert Dela Rosa, Michelle
Balibrea, Ma. Franchesca Destura, Rodolfo
Pathophysiology

Modifiable
Chronic Factors ↓Fiber in
Chronic use
use
of Laxatives the Diet

Fatigue/ ↓Fluid
↓Fluid oror
Stress intake of fluid

Ignoring
Ignoring the
the
Weakness urge to
urge to
defecate
defecate

Lack of
Immobility
Exercise
Medication
s
Pathophysiology (cont…)
Non-
Non-
Modifiable
Modifiable
Factors
Factors

Connective
Connective
Tissue
Tissue Disorder
Disorder
Age

Endocrine Rectal/An
Disorder al Disorder

Metabolic,
Metabolic,
neurologic
neurologic and
and
Neuromuscular
Neuromuscular
condition
condition
Pathophysiology (cont…)

Modifiable
Factors

Non-
Modifiable
Factors

Disease Process of Diverticulitis

 Pathophysiology (cont…)

ucosal Secretion
Alteration
Insensitivity
In the process
↓Myoelectrical Activity
of Rectal
of
Defecation
membrane and Muscu

↓Mixing of Stronger stimulus is

Rectal mass bec. required to produce
↓Mucosal Of ↓ propulsive
A necessary peristaltic
rush for defecation
Transport action B
Pathophysiology (cont…)
A
A

Rectal
Distention
Rectal
Distention

Intra-abdominal pressure
Intra-abdominal pressure

Stimulation of inhibitory rectoanal reflex

Stimulation of inhibitory rectoanal reflex

Inability of internal sphincter muscle to relax

Inability of internal sphincter muscle to relax

Inability of external sphincter muscle in the pelvic region to relax

Inability of external sphincter muscle in the pelvic region to relax

BACK
BACK
Pathophysiology (cont…)

Fewer than 3 bowels per week, Decreased Appetite, Indigestion, elimination of small-volume, lumpy, hard, dry stools

Constipation Straining at Stool

Fecal Retention
Intracranial pressure, Blood Pressure, Hemorrhoids formation

C
Pathophysiology (cont…)

Muscular Hypertrophy Nociceptor stimulation

Intraluminal Pressure
Colicky midabdominal or low abdominal pains

D
Pathophysiology (cont…)

Mucosa and submucosal layers will herniate through the muscular wall

Formation of Diverticula
Multiple Diverticula might form
Pathophysiology (cont…)

Stools and undigested foods might accumulate in the diverticula

It will be entrapped in the diverticula

Enlarged Diverticula
Pathophysiology (cont…)

F G

Abdominal Distention

Bowel Irregularities: Aerobic and Anaerobic The body might

intervals of constipation (-) bacilli will become consider it as a
and diarrhea opportunistic pathogens
Bloating foreign body
Nausea
Pathophysiology (cont…)

Antigen- Antibody Response

Production of WBC, lymphocytes, phagocytes
Protein use for the production of lymphocytes Production of Histamines H I J
Pathophysiology (cont…)

Production of Histamine

Vasodilation
Capillary Permeability Redness and Swelling of the Diverticula

H K
Pathophysiology (cont…)

Will use RBCs and platelets for the transport of phagocytes to the affected site
Presence of Localized inflammation

-decreased RBC
Abcess formation - Slight decrease in platelet

Diverticulitis