5 - Diverticulitis Flashcards
Increased risk for diverticulitis
Smoking
Obesity
Presentation of diverticulitis
LLQ ABD pain
Fever
Leukocytosis
Anorexia
N/V
If pt comes in with a hx of diverticulitis in the past and it looks like they’re having it now:
Just treat it
You don’t need to scan em
Differentials for diverticulitis
Slide 10
CT for diverticultis
Fat straining
Diverticula
Bowel wall thickening >4mm
CT is preferred for:
Detecting complications
Txt of diverticulitis varies by:
Presentation
Decision tree
Slide 14
Txt of diverticulitis
Uncomplicated - liquid diet and PO ABX
No advantage of using IV ABX
No need to admit unless its complicated (i.e. abscesses, onbstruction, severe pain, blah blajblajh)
Hinchey Classification
Stage 1 to 4
1 - small, confined pericolonic or mesenteric
2 - larger, extending to pelvis
3 - perf, purulent
4 - free perforation, fecal contamination
Phlegmon is
Inflammartion and infection without abscess
Abscess that measures less than 4cm and Hinchey stage 1 are often:
Admitted for IV ABX and do not require pertcutaneous drainage
Instructions for discharge
Clear diet
Oral ABX
Follow up
Return instructions
Admit if:
Intractable N/V Comorbidities Poor home support Leukocytosis High fever Elderly Immunocompromoised Persistent paon
People under 40 with diverticulitis ?
On the rise
More virulent
Higher readmission rates
