DIVERTICULITIS

Question 1

D/Dx

Answer 1

Appendicitis
IBD
Colon CA
IBS
Pseudomembranous colitis
Peritonitis
Obstruction

Renal Colic
Ectopic
Ovarian Torsion
Testicular Torsion

Question 2

Labs / Imaging

Answer 2

CBC
Urinalysis
CRP

CXR - rule out free air.

CT Abdo & Pelvis with IV and Oral contrast

Question 3

Imaging: indications, type

Answer 3

Indications: if no previous episodes, or different episode, failure of treatment

CT with IV and Oral contrast

Question 4

CT Findings

Answer 4

fat stranding around the affected colon

location & size of any abscesses that may require drainage (fluid collections <4cm are usually too small to be drained).

Question 5

Initial Management: Uncomplicated

Answer 5

Liquid Diet
+/- Oral Antibiotics
Analgesia

Question 6

Antibiotics: Uncomplicated

Answer 6

Metronidazole 500 mg PO bid
AND
Ciprofloxacin 500 mg PO bid

Question 7

Disposition: Uncomplicated

Answer 7

Follow up q weekly

Colonoscopy in 6 after resolution if no documented colonoscopy

Question 8

Initial management: complicated

Answer 8

NPO
IVF
Analgesia
Antiemesis
Antibiotics
Surgical Consultation

Question 9

Complications

Answer 9

Abscess
Phlegmon
Perforation
Obstruction
Sepsis / Septic Shock
Fistula