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Diverticulitis
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Diverticulitis

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Contributors: Michael W. Winter MD, Khaled Bittar MD, Nishant H. Patel MD, Desiree Rivera-Nieves MD
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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 over 50 years of age.

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. Computed tomography (CT) of the abdomen and pelvis confirms the diagnosis in most instances.

Treatment is determined by severity and complexity of diverticulitis. Mild cases can be managed as an outpatient with oral antibiotics, with more severe cases requiring intravenous antibiotics. Complicated diverticulitis may require surgery 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:
K57.30 – Diverticulosis of large intestine without perforation or abscess without bleeding

SNOMEDCT:
307496006 – Diverticulitis

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Last Reviewed: 12/08/2016
Last Updated: 11/01/2018
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Diverticulitis
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Diverticulitis : Diarrhea, Constipation, Suprapubic pain, Low grade fever, LLQ pain
Imaging Studies image of Diverticulitis
Axial image from CT scan of abdomen and pelvis with wall thickening of ascending colon, with an inflamed diverticulum consistent with diverticulitis.
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