What Is Acute Diverticulitis?

Colonic diverticulum is a bag-like structure formed by the colonic mucosa protruding outward through the weak part of the intestinal wall. Diverticulum drainage can be complicated by diverticulitis, and it is easy to perforate after inflammation. The disease is relatively common in Europe and the United States, and rare in China. Colonic diverticulum is divided into congenital and acquired, the acquired is more common, more common in the left colon. Diverticula can be single or multiple.

Basic Information

Visiting department

Gastroenterology

Multiple groups

Middle-aged and elderly

Common causes

Caused by weak intestinal wall and increased intestinal pressure.

Common symptoms

Symptoms are not obvious and usually manifest as abdominal pain.

Contagious

no

Causes of Colonic Diverticulitis

1. Diverticula can occur in weak points of the intestinal wall.
2. Low-fiber diet caused constipation and increased intestinal pressure.
3. When the passage is blocked, the diverticulum contents cannot flow into the intestinal cavity.

Clinical manifestations of colonic diverticulitis

1. This disease mostly occurs in middle-aged and elderly people 50 to 70 years old, and more women than men.
2. Before the diverticulum does not develop inflammation, most patients are mostly asymptomatic, and sometimes they may have mild symptoms, such as constipation, abdominal pain, abdominal distension and recessive pain and discomfort. In some patients, abdominal pain is paroxysmal, which may disappear or worsen after a period of time.
3. In acute diverticulitis, the symptoms are mostly obvious. Pain in the left or lower abdomen is noticeable, sometimes accompanied by nausea, vomiting, and elevated body temperature and white blood cell count.
4. Bladder irritation symptoms such as frequent urination, urgency, and dysuria can occur near the bladder.
5. Chronic manifestations may occur after repeated attacks, such as refractory constipation, and some patients may have blood in the stool.

Colonic diverticulitis examination

1. Laboratory examination showed an increase in white blood cell count.
2. If there is free perforation on the X-ray film, free gas under the diaphragm is visible.
3. B-mode ultrasound of the abdomen showed thickening of the intestinal wall and the presence or absence of peripheral abscesses.
4. CT scan CT scan can show the inflammatory manifestation of fat around the colon. Fistulas and abscesses can be seen in almost all cases, which is extremely helpful for diagnosis.
5. Barium enema showed diverticulum or multiple diverticulum. During diverticulitis, the bowel wall is irregular, and the bowel is slightly progressively narrowed. In severe cases of diverticulitis, it is generally inappropriate to check to avoid intestinal perforation.
6. The presence of multiple diverticula can be seen in fiber colonoscopy and other diseases can be ruled out. However, fiber colonoscopy may induce perforation, so fiber colonoscopy is generally not recommended in severe diverticulitis.

Colon diverticulitis diagnosis

1. Diverticulum was confirmed to exist.
2. Clinical evidence for inflammatory response.
3. According to the location, signs and clinical characteristics of diverticulum, it is proved that this inflammatory response is related to diverticulum, or that other diseases except diverticulum are related to inflammation.
4. Increased white blood cell count.
5. X-ray, barium enema, CT examination, etc. can help diagnosis.

Colon diverticulitis treatment

1. Non-surgical treatment (1) General treatment to maintain smooth stool, eat more high-fiber foods. Gastrointestinal decompression, infusion treatment, and bed rest should be continued when fistulas and obstructions appear. In the acute phase, the author should actively perform medical treatment.
(2) Drug therapy. Broad-spectrum antibiotics are combined with drugs that are effective against anaerobic bacteria, and given intravenous fluids and nutritional support. In mild cases, antibiotics can be taken orally in an outpatient setting and the bowel can be rested.
2. Surgical treatment of patients with poor drainage of abscess, diffuse peritonitis, persistent intestinal obstruction or fistula formation, major bleeding, etc. that are not effective after conservative treatment or repeated major bleeding within a short period of time are feasible surgical treatment.