Acute Abdomen Mark II Flashcards
What is diverticulosis?
small herniations of mucosa through the muscularis. It can be congenital or acquired,though acquired is much more common
Why does diverticulosis happen?
Congenital or acquired
Lack of collagen weakens the muscularis propria, typically adjacent to terminal arterial branches and taenia coli.
INcreases incidence with age as disordered motility, hypereastosis and collagen abnormalities
What are the complications of dicverticulosis?
DIverticular disease
Diverticulitis
Diverticular bleeding
Bowel obstruction
What is diverticular disease?
diverticulosis with chronic symptoms e.g. colicky left lower abdominal pain relieved by flatus, bloating, constipation, rectal bleedin
What is diverticulitis?
inflammation of a diverticulum. This presents with fever, tachycardia, left lower quadrant pain, nausea and vomiting, and change in bowel habit
WHat are the complications of diverticulitis?
istula formation, abscess formation, perforation and peritonitis
o Fistulas include enterocolic, colovaginal, colovesical (pneumaturia, frequent UTI)
o Diverticular abscess is suggested by a swinging fever
What investigations should be done in diverticulitis?
FBC, U&Es, LFTs, clotting, and group + save
- Plain erect CXR and AXR to exclude perforation
- Contrast enhanced CT is the gold standard investigation
Investigation of diverticular bleeding is usually with colonoscopy, however angiography can also be used
How is diverticular disease managed?
Cons: Increase fibre, mebeverine can be used
Diverticulitis can be treated at home with fluids + abx. If pts cannot tolerate pain/oral intake admit
How is diverticulitis managed?
IV broad spec abx (eg coamox)
Analgesia
NBM
In complicated diverticulitis there may need to be surgery:
in perf, harmanns is used as enables reversal
abscesses may need ct guided drainage
