Diverticular Disease

Question 0

Complications of diverticulosis

Answer 0

Perforation
Haemorrhage
Fistulae
Abscesses
Post infective strictures

Question 1

Definition of diverticular disease

Answer 1

Outpouching of the gut wall.

Question 2

Symptoms of diverticulosis

Answer 2

Altered bowel habit
Left-sided colic relieved by defecation
Nausea
Flatulence

Question 3

Stages of infective complications of diverticulosis

Answer 3

Stage 1: pericolic or mesenteric abscess - surgery rarely needed
Stage 2: walled off or pelvic abscess - may resolve without surgery
Stage 3: generalised purulent peritonitis - surgery required
Stage 4: generalised faecal peritonitis - surgery required

Question 4

Initial management of diverticulitis

Answer 4

Mild - at home with bowel rest (fluids only) +/- abx

Question 5

Diagnosis of diverticulosis

Answer 5

Colonoscopy (incidental finding)
Barium enema
CT abdomen (acute diverticulitis)
Erect CXR or USD can detect perforation, free fluid, and collections