Diverticulitis
Definition
Inflammation or infection of diverticular pockets of the bowel
Cause
probably initiated by blockages or obstruction about the diverticular pockets
Symptoms
abdominal pain
diarrhoea or other change of bowel habit
PR bleeding or mucous
fever
Signs
tender abdomen - especially LIF
palpable mass
distention
Investigations
routine bloods:
FBC
,
CRP
,
U&E
blood cultures if septic
AXR if consider obstruction/perforation
Management
If systemically well:
consider a no antibiotic prescribing strategy
simple analgesia
advise the person to re-present if symptoms persist or worsen.
If systemically unwell, immunosuppressed or has significant comorbidity:
Oral antibiotics - co-amoxyclav or, if sensitive, trimethoprim + metronidazole or cephalexin + metronidazole
IV antibiotics for those with
complicated
diverticulitis - eg. perforation, obstruction, abscess, fistula, and sepsis
referral to Surgical Team if thought to be complicated
Author: Dr Dylan Jenkins Oct 2023.
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