Gastro Pt 2

Question 1

What is diverticula disease (diverticulosis)?

How is it different to diverticulitis?

Answer 1

Diverticulosis is the presence of diverticula (small outpouchings of colonic mucosa/submucosa through to the muscular layer)

Diverticulitis is when one of these pouches becomes acutely inflamed (often infectious) and symptomatic.

Question 2

What is Meckel’s diverticulum?

Answer 2

Congenital diverticulum that often presents in infancy, but can present in adults.

Question 3

What is the presentation of diverticular disease?

Answer 3

Usually asymptomatic

Non-specific GI issues: pain, bloating, constipation +/- diarrhoea

Altered bowel habit

Question 4

What is the presentation of acute diverticulitis?

Answer 4

• LIF pain + guarding
• Diarrhoea, PR mucus or blood
• Fever
• Anorexia, nausea, vomiting
• May be preceded by several months of altered bowel habit

Perforated diverticulitis - sudden onset pain and peritonitis

Question 5

How may a perforated diverticulitis present?

Answer 5

• Sudden onset pain

- Peritonitis

Question 6

What are complications of a perforated diverticulitis?

Answer 6

• Fistulae
• Abscesses
• Peritonitis
• Strictures may form during healing after diverticulitis —–> obstruction

Question 7

What is a risk factor for diverticulitis?

Answer 7

• Low fibre diet

- Majority of pts >50 years old

Question 8

What are investigations for diverticulitis?

Answer 8

Bloods: FBC (increased WCC)

Imaging: CT abdo

Colonoscopy (if diagnostic doubt or suspected cancer)

Question 9

What is the management of acute diverticulitis?

Answer 9

Medical:

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