Diverticular Disease Flashcards
diverticulosis vs Diverticular disease
Both mean diverticula are present but Diverticular disease means there are also symptoms present
What is diverticulitis?
When the diverticula become inflamed
Are diverticula congenital or aqquired?
They can be either
Diverticula can occur in the small bowel too but which type are more important?
Colonic diverticula
Where do they mostly occur in the colon?
Sigmoid colon
What is usually the cause of acquired diverticula?
Low fibre diet increases intraluminal pressures and thus causes the wall of the GI mucosa wall to herniated through weak spots in the smooth muscle to form diverticula
While the majority of those with diverticula are ASYMPTOMATIC, what complications can arise?
Altered bowel habit, colic relieved by defecation, nausea, flatulence
What investigations are usually diagnostic in diverticula disease?
Incidentally found on colonoscopy, barium enema and abdo CT is best
Why might you try and avoid colonoscopy and enema in patients with diverticula?
As there is a risk it will cause bowel perforation
What is the difference between the features of diverticulitis and diverticular disease?
Diverticulitis involves all of the features of Diverticular disease with: pyrexia, raised WBC, raised CRP/ESR, tender colon or general peritonitis
Which patients should be closely monitered?
Those who are immunocomprimised as they present late with lethal complications
What might suggest perforation of the bowel?
Ileus, peritonitis and shock
What is the treatment for perforation?
Resuscitation and Hartmann procedure (or primary anastamosis if possible)
What is the associated mortality with bowel perforation?
40%
What other complications of diverticulitis may occur?
Haemorrhage, fistulae, abscesses, post-infective strictures
