diverticulitis
DIVERTICULITIS
Diverticulitis is the acute inflammation of the diverticulum or saclike protrusion from the wall of the intestines caused by injury and bacterial proliferation. 
Abdominal pain is usually localized to the left lower quadrant, is abrupt, steady, severe and worsens over time.
Other signs and symptoms are fever, anorexia, nausea, vomiting, and altered bowel movements especially constipation but may also present with diarrhea or tenesmus.

Surgical Intervention

  • Surgical treatment is usually only needed in 20-30% of patients with acute diverticulitis
  • Patients with uncomplicated diverticulitis must be monitored for complications requiring surgery

Indications for Surgery

  • Abdominal or pelvic abscesses (Hinchey stage 1 & 2)
    • Diverticular abscesses that cannot be drained completely via computed tomography (CT)-guided percutaneous procedure
    • Laparotomy may be needed if the abscess cannot be drained or no improvement in condition was noted following drainage
  • Suppurative peritonitis secondary to a ruptured abscess (Hinchey stage 3)
    • May do laparoscopic lavage & drainage
  • Intestinal perforation with fecal peritonitis (Hinchey stage 4)
    • Resection is recommended
  • Intestinal obstruction
  • Fistula formation
  • Failure of medical treatment
  • Inability to rule out cancer
  • Recurrent episodes of acute diverticulitis
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