Acute Diverticulitis

Evidence of diverticular inflammation (fever, tachycardia) with or without localised symptoms and signs

Aetiology

  • Inflammation is caused by micro-perforation of a diverticulum

Clinical presentation

Symptoms

  • Lower abdominal pain, classically left iliac fossa
  • Associated diarrhoea +/- PR bleeding
  • Malaise, fever

Signs

  • Palpable mass
  • Abdominal distension
  • Tachycardia

Investigations

  • CT
  • Bloods - elevated CRP

Management

Simple diverticulitis

  • Fluids (oral or IV)
  • Antibiotics (oral)

Complicated diverticulitis - associated abscess formation, fistula, obstruction, frank perforation

  • Hartmann’s procedure - sigmoid colon removed, and colostomy inserted
  • Abscess - drainage (percutaneous, laparoscopic lavage and drainage)