DIVERTICULOSIS.

NOTE: the small outpouchings of the colonic wall. 3 important clinical presentations are on the board:

1) Painful Diverticulosis: simple pain and discomfort in the left lower quadrant (LLQ).

 The patient is completely normal. Barium enema can be performed but colonoscopy is the imaging tool of choice. Treated with high fiber diet (bran).

2) Mild Acute Diverticulitis: acute pain in the LLQ with mild tenderness. Still there is no fever or leukocytosis. Managed the same way as for painful diverticulosis.

3) Severe Acute Diverticulitis: severe acute pain in the LLQ with marked tenderness. The patient is feverish, toxic and has a high leukocytic count. Stool may be positive for blood. CT is the investigation of choise (colonoscopy & Barium enema are CI due to high risk of perforation). Treated at hospital with IV antibiotics (Augmentin, Ticarcillin, Imipenems, 3rd generation CS, Quinolones..)