DIVERTICULAR DISEASE Flashcards
WHAT IS DIVERTICULAR DISEASE?
Diverticulum is outpouching of the mucosa through weaker areas of the bowel wall. Bacteria can overgrow within outpouching, leading to inflammation, known as diverticulitis
WHAT ARE THE RISK FACTORS FOR DIVERTICULAR DISEASE?
1) Low dietary fibre
2) Obesity
3) NSAIDS
4) Smoking
5) Alcohol
WHAR ARE THE SYMPTOMS OF DIVERTICULAR DISEASE?
1) intermittent lower abdominal pain relieved by defecation
2) Altered bowel habits
3) Nausea
4) Flatulence
WHAT ARE THE SYMPTOMS OF DIVERTICULITIS?
1) Sharp left iliac fossa pain worsened by movement and localised tenderness
2) Decreased appetite
3) Pyrexia
4) Nausea
WHAT ARE CONSEQUENCES OF A PERFORATED DIVERTICULUM?
1) peritonitis
2) sepsis
3) death
WHAT ARE THE COMPLICATIONS OF DIVERTICULAR DISEASE?
- pericolic abscess - abscess adjacent to colon
- fistula formation - between colon and bladder
- bowel obstruction - secondary to stricture formation (inflammatory process leads to fibrosis)
WHICH AREA OF LARGE BOWEL IS AFFECTED?
sigmoid colon
WHAT LABORATORY INVESTIGATIONS ARE CARRIED OUT?
1) FBC
2) CRP
3) FAECAL CALPROTECTIN
WHAT IMAGING INVESTIGATIONS ARE CARRIED OUT?
1) Diverticular disease - flexible sigmoidoscopy
2) Diverticulitis - CT abdomen- pelvis
WHAT IS SEEN ON CT SCAN?
1) thickening of colonic wall
2) abscess
3) free air
4) localised bubbles
WHAT IS THE CLINICAL STAGING SYSTEM FOR DIVERITCULITIS?
Hinchey classification
WHAT IS THE INITIAL MANAGEMENT FOR DIVERTICULITIS?
1) IV antibiotics
2) IV fluids
3) bowel rest (clear fluids orally then advance to low residue diet)
4) analgesia
WHAT IS THE INITIAL MANAGEMENT FOR DIVERITICULAR DISEASE?
1) simple analgesia
2) oral fluid intake
WHAT IS THE MANAGEMENT FOR PERITONITIS?
IV fluids
Antibiotics
WHAT IS THE SURGICAL MANAGEMENT?
1) Hartmann’s procedure - sigmoid colectomy with formation of end colostomy
