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Complicated diverticulitis is treated with antibiotics and may require surgical interventions such as abscess drainage or fistula repair. [8] Pain is managed with antispasmodics or acetaminophen, rather than NSAIDs (ibuprofen, aspirin, etc.). [16] Antibiotics should be used selectively in most cases of uncomplicated diverticulitis.
Indications for surgery are abscess or fistula formation; and intestinal rupture with peritonitis. [40] These, however, rarely occur. [40] Emergency surgery is required for peritonitis with perforated diverticulitis [63] [66] or intestinal rupture. [72] Surgery for abscess or fistula is indicated either urgently or electively.
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 .
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.
An abdominal examination may be performed because the physician suspects a disease of the organs inside the abdominal cavity (including the liver, spleen, large or small intestines), or simply as a part of a complete physical examination for other conditions. In a complete physical examination, the abdominal exam classically follows the ...
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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]
Hinchey Classification is used to describe perforations of the colon due to diverticulitis. The classification was developed by Dr. E John Hinchey (1934–present), a general surgeon at the Montreal General Hospital and professor of surgery at McGill University. Diverticulosis (the presence of bowel diverticula) is an essentially ubiquitous ...
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