Diverticular disease - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Diverticular disease is usually asymptomatic; patients may have constipation or nonspecific abdominal symptoms.
Symptomatic acute diverticulitis presents with fever, leukocytosis, and left lower quadrant pain.
Colonoscopy is a common diagnostic test for diverticular disease. Computed tomography scan is the imaging modality of choice for acute diverticulitis and complicated diverticular disease, and has largely replaced contrast enema.
Treatment includes bowel rest, analgesics, antibiotics, and surgical intervention.
Complications include bleeding, infection, segmental colitis, perforation, abscess, peritonitis, fistula, and obstruction.

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

American College of Radiology. ACR appropriateness criteria: left lower quadrant pain. 2023 [internet publication].[Full Text]
Peery AF, Shaukat A, Strate LL. AGA Clinical practice update on medical management of colonic diverticulitis: expert review. Gastroenterology. 2021 Feb;160(3):906-11.e1.[Abstract][Full Text]
Hall J, Hardiman K, Lee S, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the treatment of left-sided colonic diverticulitis. Dis Colon Rectum. 2020 Jun;63(6):728-47.[Abstract][Full Text]
Qaseem A, Etxeandia-Ikobaltzeta I, Lin JS, et al. Diagnosis and management of acute left-sided colonic diverticulitis: a clinical guideline from the American College of Physicians. Ann Intern Med. 2022 Mar;175(3):399-415.[Abstract][Full Text]
Sartelli M, Weber DG, Kluger Y, et al. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting. World J Emerg Surg. 2020 May 7;15(1):32.[Abstract][Full Text]
Stollman N, Smalley W, Hirano I; AGA Institute Clinical Guidelines Committee. American Gastroenterological Association Institute guideline on the management of acute diverticulitis. Gastroenterology. 2015 Dec;149(7):1944-9.[Abstract][Full Text]

Referenced Articles

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