5-Minute Emergency Consult
Diverticulitis
Diverticulitis is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Micro- or macroscopic perforation of diverticulum:
- Uncomplicated (75%) vs. complicated (25%)
- Increased incidence:
- Increased diverticular disease = increased diverticulitis
- Increased incidence attributed to increased prevalence of western diet
Etiology
Etiology
- Fecal material in diverticulum hardens, forming fecalith, increasing intraluminal pressure
- Erosion of diverticular wall leads to inflammation and bacteria translocation
- Focal necrosis leads to perforation
- Microperforation: Uncomplicated diverticulitis:
- Colonic wall thickening
- Inflammatory changes (fat stranding on CT)
- Macroperforation: Complicated diverticulitis:
- Abscess
- Bowel obstruction
- Fistulas after recurrent attacks
- Colovesical fistula (most common) presents with dysuria, frequency, urgency, pneumaturia, and fecaluria
- Peritonitis
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Basics
Description
Description
- Micro- or macroscopic perforation of diverticulum:
- Uncomplicated (75%) vs. complicated (25%)
- Increased incidence:
- Increased diverticular disease = increased diverticulitis
- Increased incidence attributed to increased prevalence of western diet
Etiology
Etiology
- Fecal material in diverticulum hardens, forming fecalith, increasing intraluminal pressure
- Erosion of diverticular wall leads to inflammation and bacteria translocation
- Focal necrosis leads to perforation
- Microperforation: Uncomplicated diverticulitis:
- Colonic wall thickening
- Inflammatory changes (fat stranding on CT)
- Macroperforation: Complicated diverticulitis:
- Abscess
- Bowel obstruction
- Fistulas after recurrent attacks
- Colovesical fistula (most common) presents with dysuria, frequency, urgency, pneumaturia, and fecaluria
- Peritonitis
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Citation
Schaider, Jeffrey J., et al., editors. "Diverticulitis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307608/2.3/Diverticulitis.
Diverticulitis. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307608/2.3/Diverticulitis. Accessed September 24, 2021.
Diverticulitis. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th edition). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307608/2.3/Diverticulitis
Diverticulitis [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2021 September 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307608/2.3/Diverticulitis.
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