What Is Perforated Diverticulitis?

The intestinal wall is composed of a mucosal layer, a muscular layer, and a serosa layer from the inside to the outside. Diverticulum is formed by the intestinal mucosa layer being pressed into the lattice-like structure of the colon muscles due to long-term intestinal pressure. Colonic diverticulum can be divided into two types: congenital and acquired. The formation of diverticulum, especially in the left colon, is almost an aging phenomenon. The older it is, the more likely it is. Diverticulitis does not cause any problems, but if its opening is blocked, diverticulitis is formed.

Diverticulitis

Definition of diverticulitis

The intestinal wall is composed of a mucosal layer, a muscular layer, and a serosa layer from the inside to the outside. Diverticulum is formed by the intestinal mucosa layer being pressed into the lattice-like structure of the colon muscles due to long-term intestinal pressure. Colonic diverticulum can be divided into two types: congenital and acquired. The formation of diverticulum, especially in the left colon, is almost an aging phenomenon. The older it is, the more likely it is. Diverticulitis itself does not cause any problems, but if its opening is blocked, diverticulitis develops.

Symptoms of diverticulitis

In the absence of complications, diverticulum is asymptomatic. When inflamed, depending on its location and severity, symptoms may be abdominal pain, constipation or diarrhea, blood in the stool, fever or chills, nausea and vomiting. The abdominal pain caused by colonic diverticula is usually located in the left lower abdomen, but it can also occur in any part with diverticulum. For example, the pain of right colon diverticulitis is similar to that of appendicitis, which makes diagnosis difficult. Abdominal pain usually occurs suddenly and lasts for hours or days. It is often accompanied by abdominal tenderness in the inflamed area and sometimes symptoms of peritonitis. Patients with colonic diverticula often have constipation. When diverticulitis occurs, the patient may experience symptoms of diarrhea and constipation alternately. In severe cases, he may have nausea and vomiting, or even blood in the stool. In addition, severe chronic diverticulitis occasionally forms fistulas with nearby organs, and fistulas with the bladder are common, and symptoms of gasuria or feces appear. Another complication of diverticulum is massive bleeding, which is an indication for surgery. Patients with a large amount of bleeding often have a sudden large amount of blood in the stool without inflammation, and sometimes the bleeding will stop automatically, but if continuous bleeding or repeated bleeding occurs, the intestines of the bleeding section need to be surgically removed.

Diverticulitis diagnosis

Diverticula without complications are often found by accident. The most important diagnostic tools are barium salt enema and sigmoidoscopy. Chronic diverticulitis often causes lesions such as colon deformation and bowel stenosis, which are difficult to distinguish from colorectal cancer under x-rays. Occasionally, barium salt enemas can reveal leaks into the abscess cavity or into the sacral canal of nearby organs.

Diverticulitis Treatment

Diverticulitis can usually be treated with medical therapies; most episodes of diverticulitis can be cured with intravenous antibiotics, and some more severe patients should be fasted, inserted into the nasogastric tube and given intravenous fluids. Regular maintenance should maintain normal bowel movements and avoid constipation. For those patients with recurrent diverticulitis that are ineffective for medical treatment, surgery can be performed to remove the diseased colon segment. Urgent surgery is also often needed if one of the following complications occurs: perforation, sacral canal formation, large intestinal obstruction, or heavy bleeding.