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Diverticulitis

Diverticulitis is a topic covered in the 5-Minute Emergency Consult.

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Emergency Central

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Basics

Description

  • Micro- or macroscopic perforation of diverticulum
    • Uncomplicated (75%) vs. complicated
  • Incidence increasing
    • Obesity is a risk factor

Etiology

  • Fecal material in diverticulum hardens, forming fecalith, increasing intraluminal pressure
  • Erosion of diverticular wall leads to inflammation
  • 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

Rosen, Peter, 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/all/Diverticulitis.
Diverticulitis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307608/all/Diverticulitis. Accessed April 25, 2019.
Diverticulitis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307608/all/Diverticulitis
Diverticulitis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307608/all/Diverticulitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Diverticulitis ID - 307608 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307608/all/Diverticulitis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -