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Diverticulitis
Other Resources UpToDate PubMed

Diverticulitis

Contributors: Michael W. Winter MD, Khaled Bittar MD, Nishant H. Patel MD, Desiree Rivera-Nieves MD
Other Resources UpToDate PubMed

Synopsis

Diverticulitis is a disease characterized by inflammation in colonic diverticula. Patients classically present with abdominal pain (typically left lower quadrant), nausea and/or emesis, and fevers. Loose and sometimes bloody bowel movements can be seen as well. Diverticulitis occurs in patients who have diverticulosis, which increases in prevalence with age and is observed in the majority of patients aged older than 50 years.

The underlying etiology is thought to be due to microperforation of diverticula. Smoking, obesity, and the use of NSAIDs are associated with increased risk of diverticulosis and diverticulitis. CT of the abdomen and pelvis confirms the diagnosis in most instances.

Treatment is determined by severity and complexity of diverticulitis. Most patients with mild uncomplicated cases can be managed as an outpatient without oral antibiotics, although selective use of antibiotics is advised for some patients. Complicated diverticulitis requires antibiotic treatment, with severe cases requiring intravenous antibiotics; surgery may be required in some instances.

The Hinchey staging system classifies abscesses and free perforation:
  • Stage I – small pericolic or mesenteric abscesses
  • Stage II – abscess is larger and confined to pelvis
  • Stage III – purulent peritonitis
  • Stage IV – fecal peritonitis

Codes

ICD10CM:
K57.92 – Diverticulitis of intestine, part unspecified, without perforation or abscess without bleeding

SNOMEDCT:
307496006 – Diverticulitis

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Last Reviewed:12/07/2016
Last Updated:11/01/2022
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Diverticulitis
Imaging Studies image of Diverticulitis - imageId=6841976. Click to open in gallery.  caption: '<span>Axial image from CT scan of  abdomen and pelvis with wall thickening of ascending colon, with an  inflamed diverticulum consistent with diverticulitis.</span><br />'
Axial image from CT scan of abdomen and pelvis with wall thickening of ascending colon, with an inflamed diverticulum consistent with diverticulitis.
Copyright © 2022 VisualDx®. All rights reserved.