Diverticular disease Flashcards
What is a diverticulum?
outpouching of the gut wall
What is the difference between diverticular disease and diverticulosis?
diverticulosis - diverticula are present
diverticular disease - symptomatic
What is diverticulitis?
inflammation of diverticulum
What is the pathology underlying diverticular disease?
high intraluminal pressures force mucosa to herniate through muscle layers of the gut at weak points adjacent to penetrating vessels
Where do most diverticulae occur?
sigmoid colon
Where do most complications of diverticulum occur?
sigmoid colon
How are diverticula diagnosed?
Colonoscopy - usually common incident finding
How is acute diverticulitis confirmed?
CT abdo
NO colonoscopy - risk perforation
How does diverticular disease present?
altered bowel habit +/- L sided colic relieved by defaecation
Nausea
Flatulence
What is treatment for diverticular disease?
Anti-spasmodics e.g. mebeverine
Surgical resection
What dietary factors can contribute to diverticular disease?
low fibre diet
How does diverticulitis present?
same as DD but w pyrexia
tender colon +/- localised or generalised peritonism
↑WCC, ↑CRP/ESR
How can mild attacks of diverticulitis be managed?
at home w rest +/- abx
fluids only
How should more severe attacks of diverticulitis be managed?
admit for analgesia NBM IV fluids IV abx
What are complications of diverticulitis?
abscess formation perforation haemorrhage fistulae post-infective strictures
