Perforated diverticulitis - lower GI

Question 1

What is a diverticulum?

Answer 1

diverticulum = blind ending pouch (outpocketing from bowel) which is an area of weakness.

Question 2

What is the process that causes a diverticulum to perforate?

Answer 2

Increased pressure in these areas of weakness

–> drives the mucosa through these areas of weakness

–> mucosa can become infected + perforate.

Question 3

Which 2 factors can contribute to the formation of a diverticulum?

Answer 3

1. Focal weaknesses in the bowel wall and
2. increased lumenal pressure

Question 4

How does diverticulitis occur?

Answer 4

stool in the diverticula erode the mucosa

–> inflammation + haemorrhage

–> surface of the colon = hyperaemic

Question 5

What is the clinical presentation of perforated diverticulitis?

Answer 5

• Severe left iliac fossa pain
• Nausea
• loss of appetite
• constipation
• pyrexia
• tachycardia
• ~ tender indistinct mass lying parallel to inguinal ligament.