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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 .
Uncomplicated acute diverticulitis is defined as localized diverticular inflammation without any abscess or perforation. [46] Complicated diverticulitis additionally includes the presence of abscess, peritonitis, obstruction, stricture and/or fistula. 12% of patients with diverticulitis present with complicated disease. [47]
Fecal calprotectin, a marker of colon inflammation, may be elevated. Computed tomography of the abdomen is not routinely necessary, but may show thickening or inflammation in the distal colon (sigmoid colon) with associated diverticulosis. Treatment may consist of antibiotics, aminosalicylates (mesalamine), or prednisone. In rare cases, surgery ...
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.
Although inflammation can happen when fecal matter, or fecaliths, become lodged in the diverticula, this is thought to actually be less common, and really inflammation is thought to happen more often due to erosion of the diverticular wall from higher luminal pressures. Erosion and inflammation most commonly causes pain in the left lower quadrant.
Calyceal diverticula are usually asymptomatic, but if a stone becomes lodged in the outpouching, they may present with pain. [14] Urethral diverticula are usually found in women aged 30 to 70 years old, in between 1 and 6% of adult women. Since most cases are without any symptoms, the true incidence is unknown.
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Diverticulitis is a common condition with different presentations. Although diverticulitis may be the source of a colonic obstruction, it more commonly causes an ileus, which appears to be a colonic obstruction. [16] Endoscopic means can be used to secure a diagnosis although this may cause a perforation of the inflamed diverticular area.
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