Diverticular Disease

Question 1

Describe hinchey classification and management diverticulitis

Answer 1

• Type 1: diverticulitis with pericolic abscesses. Fluid resuscitation, antibiotics, analgesia. Do colonoscopy after 6 weeks to exclude malignancy
• Type 2: pelvic abscess confirmed on us or ct. Percutaneous drainage, antibiotics
. Type 3: generalised peritonitis from abscess rapture, purulent. peritonitis. Laparotomy with peritoneal irrigation, resect diseased Color and primary anastomosis.
• Type 4: colonic perforation and fecal peritonitis. Surgery, savage, resection with colostomy

Question 2

Name 6 indications elective resection of diverticulum

Answer 2

• Fistula: excise fistula and diverticulum, primary anastomosis
• stricture: to exclude malignancy
• recurrent infection
O immunosuppressed prophylactic
• young
A persistent symptoms (abdominal pain, bleed, fever, obstruction etc)

Question 3

Most common site bleeding diverticulum?

Answer 3

Right colon