Diverticulitis

Question 1

Right colon

Answer 1

15% of cases

Question 2

Right colon

Answer 2

15% of cases

Question 3

% that develops diverticulitis with diverticulosis

Answer 3

20%

Question 4

Indication for elective resection

Answer 4

individual

before, recommended after 2nd spike

Question 5

Hinchey I II

Answer 5

depends on size
< 3-4 cm ATB
> 3-4 cm ATB + drain
Drain left in place until clean

Question 6

Hinchey III

Answer 6

Typically have signs of sepsis
Lavage in selected cases (SCANDIV)
vs
Resection
- PA + Ileostomy
- Hartmann

Question 7

Hinchey IV

Answer 7

Hartman
vs
Primary anastomosis

Question 8

Hinchey (Classic)

Answer 8

I pericolic abscess
II covered abscess in pelvis or retroperitoneum
III free perforation pus (generalized peritonitis)
IV free perforation stool (generalized fecal peritonitis

Question 9

Honchey (Modified)

Answer 9

0 Mild clinical diverticulitis
Ia Confined pericolic inflammation, phlegmon
Ib Confined pericolic abscess
II Pelvic, distant intra-abdominal, or retroperitoneal abscess
III Generalized purulent peritonitis
IV Generalized fecal peritonitis

Question 10

Risk of perforation according to episode

Answer 10

25% in the first episode

12. 7% at second episode
13. 9% at the third episode

Question 11

Consider operating on the first episode

Answer 11

immunocompromised
chronic renal failure
collagen-vascular disease
transplant patients on chronic corticosteroid therapy