Acute diverticulitis may present with an abscess that is usually pericolonic or pelvic and can be treated with urgent surgery or percutaneous drainage. We present a case of a diverticular abscess presenting as a left inguinal hernia. [ncbi.nlm.nih.gov]

• Fever

  A 59-year-old woman with left lower abdominal pain and fever was admitted to our hospital. Abdominal computed tomography revealed diverticulitis with abscess formation. Colonoscopy revealed colonic inflammation with abscess caused by diverticulitis. [jstage.jst.go.jp]

  Fever is a typical feature (distinguishing from diverticular disease) Nausea, vomiting and anorexia may also be present Urinary symptoms may also be present due to subsequent inflammation of urinary structures. [dundeemedstudentnotes.wordpress.com]

  Clinical manifestations of diverticulitis include lower left-side abdominal pain, abdominal distention, flatulence, fever, rectal bleeding, and constipation or diarrhea. [smartypance.com]

  Constipation and fever are common symptoms. Pus may collect around the inflamed diverticulum, leading to the formation of an abscess, usually in the pelvis. [health24.com]

  People who have increasing pain, tenderness, and fever also need surgery. The surgeon removes the involved section of the intestine. [msdmanuals.com]

• Weight Loss

  The clinical symptoms are nonspecific from fever and weight loss to abdominal pain. [karger.com]

  Other symptoms include nausea, loss of appetite, and weight loss. [msdmanuals.com]

  However, this is often difficult because the clinical presentation consistently has the usual markers for infection, such as fever and back pain (~30% of cases). 2 Other generalized symptoms include nausea, weight loss, and abdominal pain. [pharmacytimes.com]

  Other symptoms may include nausea, anorexia, malaise, weight loss, and groin swelling. Physical Exam Maneuvers manipulating the inflamed psoas compartment result in pain on the affected side. [unboundmedicine.com]

• Malaise

  Diverticular Disease Condition where diverticula cause intermittent pain, but without any signs of acute infection or inflammation Diverticulitis Infection and inflammation of the diverticula, usually causing marked pain, fever and malaise. [dundeemedstudentnotes.wordpress.com]

  Specific symptoms of abdominal abscesses depend on the location of the abscess, but most people have constant discomfort or pain, feel generally sick (malaise), and often have a fever. [msdmanuals.com]

  Presentation is of LIF tenderness, possibly with fever and malaise. A tender mass may be palpated, indicating the presence of an inflammatory mass. There may be leukocytosis on FBC and an elevated CRP. [gponline.com]

  Other symptoms may include nausea, anorexia, malaise, weight loss, and groin swelling. Physical Exam Maneuvers manipulating the inflamed psoas compartment result in pain on the affected side. [unboundmedicine.com]

• Unconsciousness

  […] gender [ 51 ] Significant cardiac disease [ 38, 62 ] Malignancy [ 67 ] Significant liver disease/cirrhosis [ 48, 50, 61, 62 ] Peripheral vascular disease [ 63 ] Significant renal disease/renal replacement therapy [ 48, 61, 62 ] Alcohol abuse [ 63 ] Unconsciouness [liebertpub.com]

• Abdominal Pain

  Abdominal CT scan is not always a definitive and absolute imaging modality for abdominal pain evaluation and cannot supplant clinical judgment in the evaluation of confusing cases. [ncbi.nlm.nih.gov]

  A 59-year-old woman with left lower abdominal pain and fever was admitted to our hospital. Abdominal computed tomography revealed diverticulitis with abscess formation. Colonoscopy revealed colonic inflammation with abscess caused by diverticulitis. [jstage.jst.go.jp]

  If you have significant abdominal pain, seek the advice of Dr. Fall. [fallgeneralsurgery.com]

  When to see a doctor Call your doctor if you have: Severe abdominal pain Pain that is localised to one area of the abdomen and lasts longer than four hours Abdominal pain accompanied by a fever Stools that are dark red, black or tarry – this usually means [health24.com]

  What Is the Medical Treatment For Mild Abdominal Pain Due To Diverticular Disease? There are some medications that can treat mild symptoms such as abdominal pain due to muscle spasm. [onhealth.com]

• Constipation

  Diets low in fiber cause stool to be harder, and can lead to constipation. Constipation can cause repeated straining during bowel movements, and can increase the pressure in the colon, which can lead to the formation of diverticula. [onhealth.com]

  Fiber prevents constipation by making the stool soft and easier to pass. Constipation makes the muscles in the colon work strenuously to move the hard stool, which increases pressure. [charlottegastro.com]

  A high-fibre diet helps to prevent constipation and formation of diverticula. Exercising regularly and drinking enough water (up to 8 cups a day) are also recommended. [healthdirect.gov.au]

  Presents with constipation. LLQ pain, Fever, ↑ WBC, and may bleed Dignose with CT scan and no oral contrast CT will demonstrate fat stranding and bowel wall thickening. [smartypance.com]

  The sigmoid colon is part of the lower large intestine and can become strained during constipation, potentially increasing the risk of diverticulitis. [everydayhealth.com]

• Left Lower Quadrant Pain

  Her earlier history was essentially negative except for occasional pains in the left lower quadrant during the past five years. These pains were relieved by a bowel movement and were more severe when the patient was constipated. [pubs.rsna.org]

  Patient History A 73 year-old female presented to the emergency room with a 5-day history of left lower quadrant pain, fever and leukocytosis. [veranmedical.com]

  Diverticulitis will present as → a 67-year-old man with a long history of constipation presents with steady left lower quadrant pain. Physical exam reveals low-grade fever, mid-abdominal distention, and lower left quadrant tenderness. [smartypance.com]

  Signs and symptoms usually found The most common symptom of acute diverticulitis is left lower quadrant pain. Other common symptoms include low-grade fever, nausea, vomiting, constipation, and diarrhea. [clinicaladvisor.com]

  GI bleeding in adults Can present with abdominal pain in patients with chronic constipation Diverticulitis Low-grade fever Sigmoid colon most commonly affected → left lower quadrant pain Possibly tender, palpable mass (pericolonic inflammation ) Change [amboss.com]

• Acute Abdomen

  Diverticulosis involving the transverse colon, however, is a rare finding and a perforated diverticulum of thehepatic flexure is seldom considered in the differential diagnosis of acute abdomen. [sages.org]

  abdomen References: [5] [8] [9] We list the most important complications. [amboss.com]

  Infective complications according to duration of antibiotic treatment in acute abdomen. Int J Infect Dis 2004 ;8:155–162. Crossref, Medline, Google Scholar 619 Hughes MJ, Harrison E, Paterson-Brown S. [liebertpub.com]

• Hyperactive Bowel Sounds

  bowel sounds Absent bowel sounds (perforation) Generalized abdominal pain with rebound and guarding (perforation) Urinary tract findings (colovesicular/colovaginal fistula) include suprapubic, flank, costovertebral tenderness; pneumaturia (air in urine [emedicine.medscape.com]

• Muscle Strain

  Because of the vague clinical presentation of a psoas infection, it can easily be misdiagnosed as diverticulosis, appendicitis, muscle strain, meralgia paresthetica, sciatica, pyelonephritis, septic arthritis of the hip, or abdominal aortic aneurysm. [pharmacytimes.com]

  Constipation makes the muscles strain to move stool that is too hard. It is the main cause of increased pressure in the colon. This excess pressure might cause the weak spots in the colon to bulge out and become diverticula. [longislanddigestive.com]

• Lacrimation

  […] caruncle - see Inflammation, lacrimal, passages, acute gland - see Dacryoadenitis passages (duct) (sac) - see Inflammation, lacrimal, passages, acute lacunar N34.0 ICD-10-CM Diagnosis Code N34.0 Urethral abscess 2016 2017 2018 2019 Billable/Specific [icd10data.com]

• Erythema

  […] colitis56MDiverticulitisMucus fistulaN/AN/AEndoscopic index of 8N/ADiversion colitis8Triantafillidis et al [31]1991Greece64FDiverticula with perforationHartman's type of operation laparotomy16 moBloody rectal dischargeEndoscopic index of 9 (quite inflamed with friability and erythema [wjgnet.com]

  These include Skin Pyoderma gangrenosum - ulcerations which typically occur on the legs Erythema nodosum - nodular eruption on the legs. [newcastlecolorectalsurgery.com.au]

  Mild diverticular inflammation may also be revealed during colonoscopy that is remarkable for erythema, edema, or granulation tissue found at a diverticular opening. There may also simply be friable mucosa observed in the area of diverticula. [clinicaladvisor.com]

• Night Sweats

  Other symptoms may include: Constipation Discharge of pus from the rectum Fatigue, fever, night sweats, and chills Redness, painful and hardened tissue in the area of the anus Tenderness In infants, the abscess often appears as a swollen, red, tender [medlineplus.gov]

  Her systemic review was insignificant for fever, night sweat, diarrhea, blood in stool, loss of weight, and poor appetite. Fig. 1. [karger.com]

• Suggestibility

  Our studies suggest that a combined radiological-surgical approach has the potential to reduce morbidity and hospital costs without increasing mortality in the management of perforated colon diverticulitis with associated abscess formation. [ncbi.nlm.nih.gov]

  Air in the bladder in the presence of a nearby segment of diverticulitis is suggestive of a colovesical fistula. If this type of fistula is suspected, the administration of rectal contrast material may be helpful. [emedicine.medscape.com]

  It has also been suggested that microperforation of diverticula could be a cause of diverticular disease symptoms (i.e. without causing an acute diverticulitis) In any case, acute diverticulitis is thought to be a result of a perforated diverticulum. [dundeemedstudentnotes.wordpress.com]

  Some expert panels suggest a “step-up approach” to imaging for diverticulitis to decrease the exposure to ionizing radiation. [ahcmedia.com]

• Pelvic Pain

  The most common symptoms of diverticulitis are abdominal or pelvic pain, abdominal tenderness and fever called simple diverticulitis. There can be several secondary complications of an attack of diverticulitis. [fascrs.org]

  and a pelvic exam may offer additional information to help distinguish between abdominal and pelvic pain. [ahcmedia.com]

• Hematuria

  […] fistula, colovesical fistula, contamination, CR potpourri, Crohns disease, CT, cystogram, descending colon, diarrhea, diverticular disease, diverticulitis, drainage catheter, enterocutaneous fistula, fallopian tube, female, fistula tract, Foley catheter, hematuria [sages.org]

  A group at Yale noted the following trends with regard to intra-abdominal fistulae: Fistula from diverticular disease — older patients with pneumaturia Fistula from neoplasms — fecaluria, gastrointestinal symptoms, and hematuria Fistula from Crohn’s disease [worldgastroenterology.org]

See Workup for more detail. Treatment of diverticulitis The management of patients with diverticulitis depends on their presentation severity, presence of complications, and comorbid conditions. [emedicine.medscape.com]

• Colonic Stricture

  Complications include diverticular haemorrhage, colonic diverticulitis (Table 2.2), abscess formation, perforation, fistula and colonic stricture formation (see Fig. 2.31). [europeanmedical.info]

  Colonic Stricture: repeated bouts of diverticulitis with the ensuing inflammation can cause narrowing of the colon that results in an obstruction and difficulty in passing bowel movements. [athensherniaclinic.com]

  A colonic stricture or fistula. A history of multiple attacks may result in a patient deciding to undergo surgery to prevent future attacks. Surgery for diverticular disease usually involves removal of the affected part of the colon. [fascrs.org]

  A blocked colon (bowel obstruction) or a narrow spot in the colon (stricture). Infection that has spread through the blood to other parts of the body (sepsis). [northshore.org]

  Stricture With Colonic Obstruction Colonic obstruction due to acute diverticulitis is uncommon. [clevelandclinicmeded.com]

• Neutrophilia

  Any further features of inflammation, such as pyrexia or neutrophilia, may indicate diverticulitis. Pain is generally exacerbated by eating and diminished with defecation or flatus. [patient.info]

Failure of initial treatment required urgent surgery in 8 patients with persistent symptoms during treatment with antibiotics alone (25 %) and in 21 patients (18 %) after initial percutaneous drainage (p = 0.21). [ncbi.nlm.nih.gov]

Failure of initial treatment required urgent surgery in 8 patients with persistent symptoms during treatment with antibiotics alone (25 %) and in 21 patients (18 %) after initial percutaneous drainage ( p = 0.21). [link.springer.com]

Treatment is the same in both cases, unless complications occur. Initial treatment Treatment for diverticulitis depends on how bad your symptoms are. [northshore.org]

The prognosis varies if complications develop and is particularly serious in the case of peritonitis. About 90% of people who have a colon resection do not have symptoms return after the surgery. [drugs.com]

[…] gas and fluid into pelvis and peritoneal cavity abscess formation (seen in up to 30% of cases) may contain fluid, gas or both fistula formation (usually a chronic complication) gas in the bladder direct visualization of a fistulous tract Treatment and prognosis [radiopaedia.org]

Children have a favorable prognosis with prompt diagnosis and treatment. Complications Inadequate treatment associated with unfavorable outcomes. About 40% of patients require >1 drainage procedure for full recovery ( 5 ). [unboundmedicine.com]

Prognosis and Prevention Fortunately, colon abscess drainage and treatment is uncommon but possible with proper care. Most people who experience a colon abscess and receive proper treatment resume all normal activities within a few weeks. [lacolon.com]

What caused the abscess and a person's general medical condition affect the prognosis more than the specific nature and location of the abscess. [msdmanuals.com]

Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. [books.google.com]

Pyogenic psoas abscess: worldwide variations in etiology. World J Surg. 1986;10(5);834-843. Krobot K, Yin D, Zhang Q, et al. [pharmacytimes.com]

[…] and Pathophysiology The exact etiology of diverticular disease is not known. [ahcmedia.com]

Etiology Caused mainly by lifestyle and environmental factors Increasing age Genetic factors Diet ( low-fiber, rich in fat and red meat) Obesity, low physical activity Cigarette consumption References: [2] [3] Classification Pathophysiology Diverticulosis [amboss.com]

In cases of complicated diverticular disease, where a colonic fistula is present, a colonoscopy can confirm the site and etiology of the fistula. [clevelandclinicmeded.com]

Section 1: Epidemiology and aetiology Diverticular disease (or diverticulosis) refers to the presence of diverticulae within the GI tract. [gponline.com]

[1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Epidemiology and pathophysiology of diverticular disease. Clin Colon Rectal Surg. 2009;22(3):141-146. Pelaez N, Pera M, Courtier R, et al. [consultant360.com]

As diverticulosis occurs in an older population such complications are serious events. [ citation needed ] Epidemiology [ edit ] The prevalence of diverticulosis progressively increases with age. [en.wikipedia.org]

Epidemiological evaluation of colonic diverticulosis and dietary fiber in Japan. Tohoku J Exp Med. 1993;171:145-151. 9. Heaton KW, Thompson WG. Exercise and diverticular disease. BMJ. 1995;310:1332. 10. [pharmacytimes.com]

The pathophysiology that causes symptoms is poorly understood Damage to the vasa recta vessels may result in inflammation It has also been thought that obstruction of the diverticula with faecal matter can cause an acute inflammatory reaction. [dundeemedstudentnotes.wordpress.com]

In The Large Intestine Physiology, Pathophysiology and Disease, pp. 13-35 [SF Phillips, JH Pemberton and RG Shorter, editors]. New York: Raven Press. ^ West, AB (2008). "The pathology of diverticulitis". [en.wikipedia.org]

Pathophysiology and pathology [ ✎ edit | edit source ] In diverticular disease, the bowel wall is thicker due to much more elastic tissue between the muscle fibers [2]. [wikilectures.eu]

Etiology Caused mainly by lifestyle and environmental factors Increasing age Genetic factors Diet ( low-fiber, rich in fat and red meat) Obesity, low physical activity Cigarette consumption References: [2] [3] Classification Pathophysiology Diverticulosis [amboss.com]

Epidemiology and pathophysiology of diverticular disease. Clin Colon Rectal Surg. 2009;22(3):141-146. Pelaez N, Pera M, Courtier R, et al. [consultant360.com]

Can Diverticular Disease Be Prevented? Diverticula are permanent once formed and can only be removed surgically. There is currently no treatment to prevent diverticular disease. [onhealth.com]

A normal fiber diet is advisable to prevent constipation and perhaps prevent the formation of more diverticula. [medicinenet.com]

[…] or prompt treatment of STDs may prevent an anorectal abscess from forming. [medlineplus.gov]

Rectal bleeding Formation of a narrowing of the colon that prevents easy passage of stool (called a stricture) Formation of a tract or tunnel to another organ or the skin (called a fistula). [fascrs.org]

Diverticulitis The Best and Worst Foods for Managing or Preventing Diverticulitis Eating a diet high in fiber can help prevent diverticulitis. But it’s important to avoid fiber if you have the condition. [everydayhealth.com]