Diverticulitis Flashcards

1
Q

What is the difference between diverticulosis, diverticular disease, and diverticulitis?

A

diverticulosis = formation of diverticula, herniation of mucosa and submucosa through muscular layer of the colonic wall - asymptomatic and causes no problems

Diverticular disease = any clinical state caused by symptoms pertaining to diverticula

Diverticulitis = inflammation of the diverticula

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2
Q

What RFs are there for diverticulitis?

A
low fibre intake (increases interstitial transit time, decreases stool volume --> increased intraluminal pressure)
decreased physical activity
high red meat consumption
high alcohol and caffeine intake
steroids
NSAIDs
alterations in colonic wall structure 
connective tissue abnormalities
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3
Q

What complications can occur because of diverticula?

A
fistulas
colorectal neoplasm
abscess
perforation
strictures
obstruction
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4
Q

What are some S&S of acute diverticulitis?

A
LLQ pain
change in bowel habits
N&V
Constipation/diarrhoea
Flatulence
Bloating
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5
Q

What additional symptoms would an acute diverticulitis patient present with if they also had ____?

a. peritonitis
b. fistula formation

A

a. generalised tenderness with rebound and guarding
distended abdomen
diminished or absent bowel sounds

b. purulent vaginal discharge
urinary tract symptoms if colovesicular fistulas

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6
Q

What would diagnose diverticulitis on CT?

A
pericolic fat
colonic diverticula
bowel wall thickening
soft-tissue inflammatory masses
phlegmon 
abscesses
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7
Q

How are patients with acute diverticulitis managed?

A

abx - amoxicillin/clavulanate or ciprofloxacin + metronidazole
high fibre diet
analgesia
supportive therapy

if there is acute rectal bleeding;
endoscopic haemostasis/angiographic embolization

if it’s recurrent;
colectomy laparoscopically

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