Diverticulitis

 

Diverticulitis: Inflammation, irritation or infection of existing diverticulosis in the colon.

Manifestations:

  • tenderness or pain in the lower left quadrant
  • nausea
  • vomiting
  • slight fever
  • elevated WBC

 

Diverticulitis: The diverticulosis complication

  1. inflammation with gross or microscopic perforation of the diverticulum.
  2. Perforation of the gut accompanied by peritonitis
  3. hemorrhage
  4. bowel obstruction

5. Fistulas formation:

  • usually involving the bladder
  • may involve skin
  • perianal area
  • small bowel
  • Permaturia (air in the urine) = a sign of vesicosigmoid fistula

 

diagnosis

  1. Hx
  2. CT
  3. Ultrasound
  4. Flat abdominal radiographs

 

treatment.

  1. symptoms and complication prevention
  2. increased bulk in diet to increase intracolonic pressure and promote defecation
  3. bowel retraining so the individual has at least one bowel movement per day
  4. Acute diverticulitis is treated by withholding solid food and administering a broad-spectrum antibiotic.
  5. IV fluids may be needed for those unable to tolerate oral fluids
  6. Sx reserved for complications

Martin, Glenn and Porth, Carol, Mattson. 2009. Pathophysiology Concepts of Altered Health States. 8th ed. Lippincott Williams and Wilkins. Philadelphia

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