Diverticular and Diverticulitis* Flashcards
What is Div Disease
Condition caused by diverticular (out pouches of mucosa and submucosa in sigmoid colon)
What is Diverticulitis
Inflammation of the diverticular
What is the presentation of Div Disease
Constipation
LLQ pain
Rectal bleeding
Tenderness of LLQ on DR exam
What is the presentation of diverticulitis
Fever, N+V with LLQ pain
Constipation
Fresh rectal bleeding
Diffuse tender abdomen? Perforation/peritonitis
What is the pathology of Diverticulitis
Faecal matter lodged in diverticula
or High luminal pressure erodes the wall
What is the staging for diverticulitis
1a = phlegmon 1b = pericolic/mesenteric abscess 2 = Pelvic abscess 3 = Perulant peritonitis 4 = Faecal peritonitis
How would you investigate Diverticulitis
FBC = Anaemia, Leukocytosis and neutrophilic and ESR/CRP raised U/E = AKI / Sepsis VBG = Raised lactate Blood Culture = if sepsis CT AP = Thick bowel wall
How would you identify the bleeding point in diverticulitis
CT Angiogram
What Test would you avoid in diverticulitis
Colonoscopy
What is the management of diverticular disease
Asymptomatic (no treatment) Symptomatic -Increase fibre and water If Diverticulitis suspected -Co-Amoxiclav Analgesia
What is the management of Diverticulitis
Mild = Oral antibiotics with analgesia and liquid diet
Severe
-IV fluid with analgesia
-Co-Amoxiclav
-PR bleed? Transfusion and angiography embolism
What is a surgical option in Diverticulitis
HARTMAN’S
-Bowel resection and alternate faecal pathway
What are some complications of Diverticulitis
Fistulae Abscess Perforation Haemorrhage Stricture
What is Meckel’s Diverticulum
Pediatric disorder
-No obliteration of Vutelline Duct
*2 years old/ 2 inches long/ 2ft from ileocaecal valve
Dx = Technitium scan
What are the RF for Diverticular
Marfans and ED
Ageing
Increased Colon pressure (COPD and age)
