Diverticular disease Flashcards
What is the main aetiological factor linked with divericulosis?
Low fibre diet
What site is the most commonly affected?
Sigmoid colon
Where do diverticulae occur?
Herniation of mucosa through the circular wall at the sites of arterial penetration
Symptoms of colonic diverticulae? (4)
Lower abdominal/LIF pain
Altered bowel habit
Urgency of defaecation
Episodic rectal bleeding
Management of uncomplicated diverticular disease?
High fibre diet
Antispasmodics e.g. mebeverine
Complications of diverticular disease? (4)
Inflammation e.g. diverticulitis, pericolic abscess
Obstruction (e.g. fibrotic stricture, adherent small bowel loops)
Bleeding
Fistula formation (e.g. colovesical, colovaginal, enterocolic)
Treatment of diverticulitis?
Analgesia, IV fluids, only clear fluids by mouth, antibiotics
Indications for surgery in diverticulitis?
Perforation leading to purulent or faecal peritonitis
Fistula
Obstruction
Inability to exclude carcinoma
Presentation of colovesical fistula?
Dysuria
Passage of cloudy urine
Pneumaturia
What is the difference between purulent and faecal peritonitis?
Purulent is due to rupture of a pericolic abscess; faecal is due to rupture of bowel wall
Diverticular disease is the most common pathology responsible for what symptom?
Lower GI haemorrhage
Treatment of diverticular haemorrhage?
Fluid/blood product resus
Angiographic embolisation
If that fails:
Surgical resection
