Diverticulitis and Meckel's diverticulum

Question 1

What is Meckel’s diverticulum?

Answer 1

This is a congenital defect, in which there is an out pouching in the lower part of the small intestine, which is a remnant of the omphalomesenteric duct

Question 2

How will Meckel’s diverticulum present?

Answer 2

Majority asymptomatic
Presentations are caused by complications:
- Haemorrhage
- Intestinal obstruction
- Inflammation
- Ulceration
- Malignant change

Question 3

Who is most at risk of haemorrhage in Meckel’s diverticulum?

Answer 3

Children under 2

Question 4

What is acute diverticulitis?

Answer 4

This is inflammation of diverticulae in previous diverticular disease

Question 5

What is diverticulosis?

Answer 5

This is the presence of asymptomatic outpouchings of the intestinal wall

Question 6

How will diverticulitis usually present?

Answer 6

LIF pain
Associated diarrhoea
PR bleeding
Malaise, fever
Palpable mass
Abdominal distension
Tachycardia

Question 7

What investigations can be performed in diverticulitis?

Answer 7

CT
Bloods - Elevated CRP

Question 8

How will simple diverticulitis be treated?

Answer 8

Fluids (Oral or IV)
Possible antibiotics (Oral)

Question 9

How will complicated diverticulitis be treated?

Answer 9

Hartmann’s procedure - Sigmoid colon removed and colostomy bag inserted
Abscess drainage

Question 10

What are some complications of diverticulitis?

Answer 10

Abscess formation
Fistula
Obstruction
Frank perforation