Diverticulitis Flashcards
What is the difference between diverticulosis, diverticular disease, and diverticulitis?
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
What RFs are there for diverticulitis?
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
What complications can occur because of diverticula?
fistulas colorectal neoplasm abscess perforation strictures obstruction
What are some S&S of acute diverticulitis?
LLQ pain change in bowel habits N&V Constipation/diarrhoea Flatulence Bloating
What additional symptoms would an acute diverticulitis patient present with if they also had ____?
a. peritonitis
b. fistula formation
a. generalised tenderness with rebound and guarding
distended abdomen
diminished or absent bowel sounds
b. purulent vaginal discharge
urinary tract symptoms if colovesicular fistulas
What would diagnose diverticulitis on CT?
pericolic fat colonic diverticula bowel wall thickening soft-tissue inflammatory masses phlegmon abscesses
How are patients with acute diverticulitis managed?
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