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Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—that can develop in the wall of the large intestine. [1] Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days. [1]
Diverticulitis is defined as diverticular disease with signs and symptoms of diverticular inflammation. Clinical features of acute diverticulitis include constant abdominal pain, localized abdominal tenderness in the left lower quadrant of the abdomen, nausea, vomiting, constipation or diarrhea, fever and leukocytosis .
Acute diverticulitis is thought to arise from either trauma or lack of blood flow to the existing diverticulum in the colon. The traumatic theory proposes that a fecalith, which is a hardened fecal matter, becomes trapped in a diverticulum, leading to colonic mucosa abrasion and local inflammation.
This is a shortened version of the ninth chapter of the ICD-9: Diseases of the Digestive System. It covers ICD codes 520 to 579. The full chapter can be found on pages 301 to 328 of Volume 1, which contains all (sub)categories of the ICD-9. Volume 2 is an alphabetical index of Volume 1.
About 10% of cases have a more serious cause including gallbladder (gallstones or biliary dyskinesia) or pancreas problems (4%), diverticulitis (3%), appendicitis (2%) and cancer (1%). [2] More common in those who are older, ischemic colitis , [ 5 ] mesenteric ischemia , and abdominal aortic aneurysms are other serious causes.
Unlike diverticulitis, SCAD involves inflammation of the colon between diverticula (interdiverticular mucosa), while sparing the diverticular orifices. SCAD may lead to abdominal pain, especially in the left lower quadrant, intermittent rectal bleeding and chronic diarrhea.
Common causes of an acute abdomen include a gastrointestinal perforation, peptic ulcer disease, mesenteric ischemia, acute cholecystitis, appendicitis, diverticulitis, pancreatitis, and an abdominal hemorrhage. However, this is a non-exhaustative list and other less common causes may also lead to an acute abdomen. [2]
When diverticula (singular: diverticulum) become sites of inflammation the condition is termed "diverticulitis" and occurs when the diveritcula become infected. This classically causes lower abdominal pain, changes in bowel habits (diarrhea or constipation) and signs of inflammation (fever/chills, nausea/vomiting).