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

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


  • 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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