Diverticular Dx Flashcards

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1
Q

What is a diverticulum

A

A sac like protrusion of the colonic wall

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2
Q

What is diverticulosis

A

Diverticular disease with no symptoms

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3
Q

Percentage of people above 70 yo that has diverticulosis

A

50%

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4
Q

What are the different evolution of diverticulosis

A

Diverticulitis => inflammation
Bleeding
Perforation
Stricture
Segmental colitis
Symptomatic uncomplicated diverticular

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5
Q

Incidence in men and women

A

Equally affected

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6
Q

Incidence in the world

A

More common in developed world even though found everywhere

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7
Q

What are some hypothesis when it comes to lower incidence in Africa

A

Lower life expectancy ?
Poorer access to healthcare ?
Softer stools from high roughage ?

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8
Q

Risk factors

A

Old age
Constipation
Diet with low fibers intake
Connective tissue disorders like marfan or enhler Danilo’s syndrome
Hereditary or genetic predisposition
Extreme weight loss
Heavy meat consumption

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9
Q

Pathology

A

Not fully understood but mutltifactorial

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10
Q

Different factors contributing to pathogenesis of diverticular disease

A

Genetics
Low Fiber intak e
Low Vitamin D
Obesity
Physical inactivity
Mucosal herniation in colonic wall muscle layer
Colonic motility

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11
Q

Clinical presentation of diverticular disease

A

Mostly asymptomatic

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12
Q

What are some possible symptoms in diverticulitis

A

Constipation
Diarrhea
Fever
Chills
Nausea
Bloating
Vomiting
Cramping
Lower abdominal pain

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13
Q

What are some complications of diverticular disease

A

Abscess
Fistula
Obstruction
Peritonitis
Sepsis

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14
Q

What could you see on examination

A

Colicky pain in suprapubic area or left iliac fossa
Palpable sigmoid colon

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15
Q

What could you see on examination in the case of diverticulitis

A

Local tenderness
Guarding
Rigidity
Palpable mass
Diarrhea , rectal bleeding and fever

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16
Q

What are some differentials to diverticular disease

A

Colorectal cancer
Ischemic colitis
IBD
Infection

17
Q

How do you diagnosis diverticular disease

A

Accidentally most of the time through colonoscopy , barium enema, ct scan and flexible sigmoidoscopy

18
Q

Why cant you use colonoscopy in case. Of suspected diverticulitis

A

Can lead to perforation

19
Q

How do you manage diverticulosis with no symptoms

A

No treatment necessary
Diet fiber advised
Bulk Laxatives possible

20
Q

In a case of symptomatic diverticulosis , how do you manage

A

Based on severity :
Clear liquid diet
Oral antibiotics
Drainage if abscess
Surgery

21
Q

Indication for surgery

A

No improvement after therapy
Persistent symptoms due to diverticulitis
Compromised immune system evaluation is good
Complicated diverticulitis history
Bleeding does not stop after some time