Diverticular Disease Flashcards
What is a diverticulum
Out-pouching of gut wall
Usually at site of perforating arteries
What is diverticulosis?
Diverticulitis?
Presence of diverticula
Inflammation of diverticula, occurs when faeces obstructs the neck of the diverticulum
Aetiology of Diverticular Disease?
Could be due to a low fibre western diet
Pathophysiology of DD
Most occur at sigmoid colon
Lack of dietary fibre leads to high intra luminal pressures
This causes the mucosa to herniate through muscle layers of the gut at weak points (entry of perforating arteries)
Clinical presentation
Usually asymptomatic
Symptoms result from luminal narrowing:
Pain, constipation, bleeding
Diagnostic tests and results
Common incidental finding at colonoscopy
Barium enema
CT- to confirm acute diverticulitis
Complications of DD
Altered bowel habit
Left sided colic relieved by defecation
Nausea and flatulence
Treatment for DD?
High fibre diet will decrease luminal pressure
Antispasmodics- mebeverine
What symptoms does diverticulitis present with ?
L Iliac fossa pain
Fever
Nausea
Diverticulitis can cause bowel to perforate
What occurs if bowel perforates
May result In perforation leading to:
Abscess formation or peritonitis
OR fistula formation into bladder or vagina
Clinical signs of diverticulitis?
Fever
Tender colon +- localised/ generalised peritonitis.
Raised WCC, ESR and CRP
Treatment of diverticulitis
Analgesia Nil by mouth IV fluids ABx If abscess CT guided percutaneous drainage
