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 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]

• 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]

  See your doctor immediately if you have: very severe abdominal pain a fever start vomiting feel very unwell have blood in your poo Diverticulitis diagnosis To diagnose diverticulitis, your doctor will talk to you and examine you. [healthdirect.gov.au]

• 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]

• Perineal Pain

  A 49-year-old woman presented with perineal pain, pyuria and inflammatory reaction. Conventional MRI revealed urethral diverticulum with the content of slightly lower-signal-intensity than urine on T2-weighted contrast. [ncbi.nlm.nih.gov]

  unspecified R1011Right upper quadrant pain R1012Left upper quadrant pain R1013Epigastric pain R102Pelvic and perineal pain R1030Lower abdominal pain, unspecified R1031Right lower quadrant pain R1032Left lower quadrant pain R1033Periumbilical pain R10811Right [cms.gov]

• Inguinal Mass

  Endometrial carcinoma presenting as a large inguinal mass. Int J Gynaecol Obstet. 1989; 28 (1):67–70. [ PubMed ] [ Google Scholar ] 13. Poenaru D, Jacobs DA, Kamal I. Unusual findings in the inguinal canal: a report of four cases. [ncbi.nlm.nih.gov]

• Abdominal Pain

  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]

  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]

  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]

  Pain may be brought on with eating and may be relieved by bowel movements Altered bowel habit- commonly constipation but diarrhoea can be a symptom Bloated feeling mucus discharge PR bleeding- usually fresh or mixed with the stool (haematochezia); can [dundeemedstudentnotes.wordpress.com]

• Left Lower Quadrant Pain

  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]

  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]

  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]

• 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]

• 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]

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]

  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]

  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 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]

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 of chronic diverticulitis involves treatment of disease that is recurrent or treatment of the complications of an acute attack. [fascrs.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]

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]

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 in intra-abdominal infection: Multivariate analysis of 604 patients”. [cancertherapyadvisor.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]

Empiric antimicrobial therapy tailored to likely site and microbial etiology(s). [cancertherapyadvisor.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]

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]

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

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]

There are now studies negating the role of surgical resection to prevent recurrence of diverticulitis. [consultant360.com]