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Diverticulitis

 Syn. Diverticulitides , inflammatory disorder diverticulitis

Signs & Symptoms

 Pain present for several days
Ref: Uptodate [ Differential diagnosis of abdominal pain in adults]
Left lower quadrant pain #SUDD
Ref: Uptodate [ Diagnostic approach to abdominal pain in adults] Harrison [ 2284] Cecil [ 894] Epocrates [ https://online.epocrates.com/guidelines/1111/Acute-Diverticulitis-Dx-Tx]
Left lower quadrant abdominal pain
Ref: Epocrates [ https://online.epocrates.com/diseases/1633/Diverticular-disease/History-Exam]
Dull colicky abdominal pain #Diverticulosis
Ref: 5MinuteConsult [ https://5minuteconsult.com/collectioncontent/1-151595/diseases-and-conditions/diverticular-disease]

Physical Examination

 Melena
Ref: 5MinuteConsult [ https://5minuteconsult.com/collectioncontent/1-151595/diseases-and-conditions/diverticular-disease]
Diminished Bowel sounds
Ref: 5MinuteConsult [ https://5minuteconsult.com/collectioncontent/1-151595/diseases-and-conditions/diverticular-disease]
Pelvic tenderness
Ref: Epocrates [ https://online.epocrates.com/diseases/1631/Diverticular-disease/Diagnostic-Approach]

Lab / Serology

 Melena
Ref: 5MinuteConsult [ https://5minuteconsult.com/collectioncontent/1-151595/diseases-and-conditions/diverticular-disease]
Normal amylase
Ref: Uptodate [ Clinical manifestations and diagnosis of colonic diverticular disease]
Normal liver function tests
Ref: Uptodate [ Clinical manifestations and diagnosis of colonic diverticular disease]

Imagin Study

 CT reveal sigmoid diverticula
Ref: Harrison [ 2284]
CT reveal thickened colonic wall
Note: >4 mm
Ref: Harrison [ 2284] Cecil [ 894]
Pelvic tenderness
Ref: Epocrates [ https://online.epocrates.com/diseases/1631/Diverticular-disease/Diagnostic-Approach]

Complication

 Pyuria
Note: due to colo-vesical fistula
Ref: Epocrates [ https://online.epocrates.com/guidelines/1111/Acute-Diverticulitis-Dx-Tx] 5MinuteConsult [ https://5minuteconsult.com/collectioncontent/1-151595/diseases-and-conditions/diverticular-disease]
Elevated procalcitonin
Note: ESCP disagrees
Ref: Epocrates [ https://online.epocrates.com/guidelines/1111/Acute-Diverticulitis-Dx-Tx]
Elevated CRP
Note: ESCP disagrees
Ref: Epocrates [ https://online.epocrates.com/guidelines/1111/Acute-Diverticulitis-Dx-Tx]

Risk Factors

 Age greater than 40
Ref: Epocrates [ https://online.epocrates.com/diseases/1631/Diverticular-disease/Diagnostic-Approach]
Low dietary fiber
Ref: Epocrates [ https://online.epocrates.com/diseases/1632/Diverticular-disease/Risk-Factors]
Age > 60
Ref: Unknown [ 0]

Cause

Other