Diverticulitis Flashcards
Define diverticulosis
Diverticula are present
Define diverticular disease
Diverticula are symptomatic
Define diverticulitis
Inflammation of the diverticulum
What is a diverticulum?
An outpouching of the gut wall
Where do diverticuli commonly arise?
Where perforating arteries enter the gut wall
What is the pathophysiology behind the formation of diverticulum?
Caused by a low-fibre diet leading to high luminal pressures, causing mucosa to herniate through the muscle layers to form pouches
How do people with diverticulitis present?
Abdo pain
Altered bowel habit
Rectal bleeding
Pneumaturia (colovesical fistula, so air from bowel enters bladder)
Faeces per vaginium (colovaginal fistula, usually post-hysterectomy)
What investigations are performed fro diverticulitis?
DRE
Barium enema
Colonoscopy
Management of diverticulitis
1. Fluids and ABX at home Medical management - Treat sepsis - NBM - IV fluids - ABX - Analgesia - CT guided biopsy of abscess to avoid emergency surgery Surgical management - Hartmann's procedure for peritonitis - Resection and primary anastamosis
Give some complication of diverticular disease
Acute diverticulitis Bowel perforation Ruptured infected diverticulum Fistula Massive haemmorhage Inflammatory strictures
How does someone present with acute diverticulitis?
Acute L iliac fossa pain
Tender mass
Local peritonism
Pain is recurrent and periodic
When would you get sepsis with acute diverticulitis?
Perforated abscess
Bowel perforation
