Diverticular Disease Flashcards
What is diverticular disease often caused by?
Common surgical problem
What is diverticular disease?
Herniation of colonic mucosa through muscular wall of the colon
Where does diverticular disease normally occur?
Between the taenia coli where vessels pierce the muscle to supply the mucosa
Where is spared in diverticular disease?
Rectum since it lacks taenia
What are the symptoms of diverticular disease?
Altered bowel
Bleeding
Abdominal pain
What are the complications of diverticular disease?
Diverticulitis Haemorrhage Development of fistula Perforation and faecal peritonitis Perforation and development of abscess Development of diverticular phelgmon
What is a diverticular phlegmon?
A phlegmon is the infected and inflamed area near the abscess.
How would you diagnose diverticular disease?
Colonoscopy
CT cologram
Barium Enema
How should acutely unwell surgical patients be investigated?
Systematically
Plain abdo films
Erect CXR
Abdo CT
How is diverticular disease classified?
Hinchey clasification
I - para-colonic abscess
II - pelvic abscess
III - purulent peritonitis
IV - faecal peritonitis
How is diverticular disease treated?
Increase dietary fibre
Mild diverticulitis - ABs
Peri colonic abscesses should be drained surgically/radiologically
Recurrent episodes needing hospitalisation might indicate segmental resection
What is the management Hinchley IV perforations?
Resection and stoma
What are risk factors of diverticular disease?
Low dietary fibre
Older than 50
How do patients with diverticular disease present?
LLQ pain Leukocytosis Fever Guarding/Tenderness Bloating Constipation
