Divertic

Question 1

Divertic is the MCC of ______ and ______

Answer 1

Colonic perforation & Lower GI Bleed

Question 2

causes of Divertic

Answer 2

Fecaliths or inspissated (thickened) food particles -> inflammation

Question 3

Risks of Divertic

Answer 3

Low fiber, high fat, red meats
Sedentary, Obesity
Smokers (incr perforation risk)

Seeds, nuts, caffeine, ETOH show NO correlation!! Old school boomer advice

Question 4

Pt has Hx of divertic and presents with new mild LLQ pain w/o fever. What should you order?

Answer 4

*Pts with Hx Divertic + mild LLQ pain w/o fever do NOT need labs/imaging”

Question 5

Study of choice for Divertic?

Answer 5

CT IV Contrast
- Microperforation will show small air bubbles in abd cavity but no contrast outside of the colon

Question 6

Inpt indications for divertic?

Answer 6

Question 7

If divertic does not improve after ____ days of outpt management, they need to be admitted

Answer 7

2-3 days

Question 8

large abscesses >____cm require ABX, CT guided drainage, and poss Sx

Answer 8

4

Question 9

Should divertic abscesses be drained with endoscopy or CT guidance?

Answer 9

CT guidance

Question 10

______ Classification System determines severity of perforation

Answer 10

Hinchey Classification System
Stage I-IV with severity

Question 11

What is a frank perforation?

Answer 11

A free perforation
*Think Frank Gallagher running away *

Question 12

trmnt for Acute divertic + frank perforation

Answer 12

EMERGENT Sx