Diverticular disease Flashcards
Diverticular disease
Herniation of colonic mucosa through the muscular wall of the colon
Usual site is between the taenia coli where vessels pierce the muscle to supply the mucosa
Rectum (which lacks taenia) is often spared
Symptoms
Altered bowel habit
Rectal bleeding
Abdominal pain
Diagnosis
Colonoscopy, CT cologram or barium enema
Complications
Diverticulitis
Haemorrhage
Development of fistula
Perforation and faecal peritonitis
Perforation and development of abscess
Development of diverticular phlegmon
Diverticulosis definition
Presence of diverticula without inflammation or infection
(May also be referred to as diveritcular disease)
Diverticulitis
Inflammation and infection of diverticula
Risk factors for diverticular disease
Increased age
Low fibre diets
Obesity
Use of NSAIDs
Treatment of diverticular disease
Increase dietary fibre intake
Mild attacks of diverticulitis managed with antibiotics
Peri-colonic abscesses drained
Recurrent episodes of acute diverticulitis indicate segmental resection
Acute diverticulitis symptoms
Pain and tenderness in LIF
Fever
Diarrhoea
Nausea and vomiting
Rectal bleeding
Palpable abdominal mass if abscess has formed
Raised inflammatory markers
Severe diverticulitis management
NBM
IV abx
IV fluids
Analgesia
Urgent investigations
Urgent surgery for complications
Complications of acute diverticulitis
Perforation
Peritonitis
Peridiverticular abscess
Large haemorrhage requiring blood transfusion
Fistula
Ileus/ obstruction
