diverticulosis

Question 1

define diverticula plus risk factors

Answer 1

true diverticula: outpouching of all layers of colon wall, like mickel diverticulum

false: outpouching of mucosa and submucosa of colon like in diverticulosis

old patients, low fiber diet, chronic constipating, smoking, obesity

Question 2

symptoms of diverticulosis?

Answer 2

usually asymptomatic
PAINLESS lower GI bleeding (absent if infected)

Question 3

diagnosis and treatment of diverticulosis

Answer 3

-colonoscopy: see outpouching
no treatment is curative so only prevention of complications: high fiber diet, stop smoking, weight loss

Question 4

symptoms of diverticulitis?

Answer 4

FEVER, LLQ PAIN with possible tender mass (pericolon inflammation), lower gi bleeding is RARE

Question 5

diagnosis of diverticulitis?

Answer 5

cbc: LEOEKOCYTOSIS**
pregnancy test? rule out ectopic pregnancy, ovarian torsion and gyne emergencies

endoscopy is CONTRAINDICATED due to risk of perforation
do CT abdomen with contrast
findings: colon outpouching, signs of inflammation

complications can be noted also: peridiverticular abscess (hypodense collection with ring enhancement), perforation (pneumoperitoneum), obstruction (dilated bowel with multiple air fluid levels)

Question 6

treatment of complicated vs uncomplicated diverticulitis

Answer 6

uncomplicated: NPO, fluids, oral antibiotics
complicated: IV antibiotics and tx of complication (abscess drain, urgent surgery if perforated, tx of obstruction)

elective colectomy is recommended for complicated diverticulitis and recurrent uncomplicated

colonoscopy screening is done after 4-6 weeks to rule out malignnancy