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Foundations-GI > Diverticulitis > Flashcards

Diverticulitis Flashcards

1
Q

Define Diverticulosis

A

Presence of diverticula

Prevalence increases with age

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2
Q

Define Diverticulitis

A

inflammation of a diverticulum

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3
Q

What area does of the colon does diverticulosis predominantly effect?

A

Sigmoid colon

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4
Q

Diverticulosis clinical presentation

A
  1. Asx!: 70-80%

2. Incidental finding: colonoscopy/imaging

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5
Q

Treatment recommendation for Diverticulosis?

A
  1. High fiber diet: 20-35 g/day
  2. Adequate hydration
  3. Avoidance of seeds/nuts NOT recommended
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6
Q

What can macroperforation in acute diverticulitis result in?

A

Free air/peritonitis

=Surgical Emergency!

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7
Q

What is the MC type of acute diverticulitis?

A

Uncomplicated (simple)

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8
Q

List the acute diverticulitis complicated findings/complications

A
  1. Abscess
  2. Fistula
  3. Obstruction
  4. Perforation
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9
Q

Acute diverticulitis clinical presentation

A
  1. Progressive, steady aching LLQ pain
  2. Fever, chills
  3. Hx of diverticulitis
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10
Q

CBC findings in Acute diverticulitis

A

Leukocytosis: may be absent in elderly

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11
Q

What is the test of choice in acute diverticulitis?

A

CT scan of A/P with contrast

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12
Q

What tests are CI in the ACUTE setting of diverticulitis? Why?

A
  1. FlexSigmoidoscopy/Colonoscopy =D/t risk of perforation

2. Barium Enema: potentially leak through perforation and exacerbate peritonitis

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13
Q

UNCOMPLICATED diverticulitis treatment

A
  1. D/C home with Oral abx: Metronidazole + Cipro OR
    Metronidazole+ TMP-SMX
  2. Close f/u w/in 2 days
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14
Q

COMPLICATED diverticulitis treatment

A
  1. Admit
  2. NPO, IVF
  3. IV abx, transition to PO oral abx x10-14 days
  4. GI consult, surgery
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15
Q

What is an absolute indication for a surgical referral in acute diverticulitis?

A

Perforation with peritonitis

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16
Q

What is recommended once acute episodes of diverticulitis resolves?

A
  1. High Fiber diet

2. Colonoscopy 6-8 weeks following acute episode: exclude concomitant colon cancer

17
Q

What is a common cause of OVERT lower GI bleeding in adults?

A

Diverticular bleeding

18
Q

What side of the colon does a diverticular bleeding occur on?

A

Right side

19
Q

Diverticular bleeding clinical presentation

A
  1. Painless hematochezia

2. Blood on rectal exam

20
Q

Diverticular bleeding diagnostic test

A

Flex Sig/Colonoscopy

21
Q

Diverticular bleeding treatment

A
  1. IV fluid resuscitation
  2. Endoscopic therapy
  3. Angiographic therapy

Foundations-GI (7 decks)

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