Diverticular disease

Question 1

diverticulosis

Answer 1

-presence of diverticula usually asymptomatic

Question 2

diverticulitis

Answer 2

-inflammation of a diverticulum

Question 3

increase risks of develping diverticular disease?

Answer 3

• low fibre intake
  -increase age
  -obesity
  -NSAID

- increase in age

Question 4

symptoms of diverticulitis?

Answer 4

• constipation
• colicky pain in LIF
• local tenderness
• rectal bleeding
• fever
• diarrhoea

Question 5

treatment diverticular disease?

Answer 5

for constipation- high fibre diet, fluids, bulking laxatives

Question 6

asians symptoms diverticular disease?

Answer 6

-pain in RIGHT lower quadrant
-rectal bleeding
-constipation/ diarrhoea
-bloating

Question 7

1st line investigaiton diverticulitis

Answer 7

non contrast CT

Question 8

complications of acute diverticulitis?

Answer 8

intra abdominal abscess formation

bowel perforation or peritonitis

intestinal obstruction

sepsis

fistula into the bladder or vagina

Question 9

management of uncomplicated diverticulitis?

Answer 9

1st line= oral co amoxiclav

can’t tolerate co amoxiclav=
cafalaxin + metranidazole

Penicillin allergy= trimethoprim + metranidazole

Question 10

management of complicated diverticulitis (diverticulitis + complications)

Answer 10

1st line= IV co amoxiclav

OR

PA= IV cerufaxime + metranidazole

OR

IV amox, gent + met

PA + cephalosporin allergy= IV ciprofloxacin + met

bowel perforation= surgery

Question 11

signs of an intra abdominal abscess formed?

Answer 11

abdominal mass on examination

Question 12

signs of bowel perforation or peritonitis?

Answer 12

guarding + abdominal rigidity on examination

Question 13

signs of intestinal obstruction?

Answer 13

colicky abdominal pain, absolute constipation, vomiting or abdominal distention

Question 14

signs of fistula in bladder or vagina?

Answer 14

-faecaluria
-pyuria (high levels WBC in urine)
-passage of faeces through vagina