Background
Diverticulitis occurs when pouches in this section of the colon become inflamed, most commonly on?
What is the sigmoid (left) colon?
The hallmark location of pain in acute colonic diverticulitis.
What is the left lower quadrant?
This imaging test is the recommended first-line tool to confirm a diagnosis of acute diverticulitis when there is uncertainty.
What is a CT scan (abdominal CT)?
According to the ACP guideline, most patients with uncomplicated diverticulitis should be treated where?
What is the outpatient setting (at home)?
Elective surgery for recurrent diverticulitis involves removing the?
What is a sigmoidectomy? (Sigmoid colon)
These three factors — not just infection — are now recognized as playing key roles in the development of diverticulitis.
What are inflammation, genetics, and gut microbiome?
These red-flag symptoms — high fever, rectal bleeding, peritonitis, or suspected malignancy — generally warrant hospital admission.
What are severe/complicated presentation symptoms?
CT imaging can rule out other causes of abdominal pain and also classify diverticulitis into mild or this more serious type.
What is complicated diverticulitis? Serious secondary problems such as abscesses, perforation, obstruction, fistula formation, or intense bleeding
The ACP guideline suggests that select patients with uncomplicated diverticulitis may be managed without this commonly prescribed class of drugs.
What are antibiotics?
Patients should be encouraged to eat a diet high in this nutrient — found in fruits, vegetables, and grains
What is fiber?
In the US, over this many hospital admissions occur annually for diverticulitis, costing an estimated $2.6 billion per year.
What is 300,000?
Nausea, vomiting, and changes in bowel habits are common symptoms. The pain in diverticulitis is often described as this type — constant vs. colicky.
What is constant (steady)?
This common blood test, often elevated in infection and inflammation, is a useful lab marker when evaluating diverticulitis severity.
What is CRP (C-reactive protein)? Also accept WBC (white blood cell count).
Patients managed at home should be able to do these two things: tolerate liquids by mouth and have reliable access to this.
What is follow-up care (and home support)?
True or false: patients with diverticulitis should avoid nuts, seeds, and popcorn to prevent flares.
What is false? (Evidence does not support this restriction.)
Diverticulitis can result in these four serious complications.
What are perforation, intestinal obstruction, pericolic abscess, and fistulae?
These three clinical findings — guarding, high white blood cell count, and elevated CRP — help identify a complication of diverticulitis.
What is peritonitis on exam, (WBC > 1.5×10⁹/L, and CRP > 100 mg/dL)
Ultrasound in the office can help rule out this type of pathology, especially important in female patients with left lower quadrant pain.
What is gynecologic pathology? (ovarian cysts, endometriosis, or ectopic pregnancy)
After a first episode of complicated diverticulitis, patients should be referred for this procedure to rule out colorectal cancer.
What is a colonoscopy?
True or false? The medication — mesalamine — prevents recurrence of diverticulitis.
FALSE. Mesalamine was studied for preventing recurrent diverticulitis and found to have no benefit. It was considered a placebo
The ACP published its inaugural guidelines on acute left-sided colonic diverticulitis in this year, in the Annals of Internal Medicine.
What is 2022?
Per the ACP guideline, CT imaging is especially recommended at the initial episode because...
A complicated disease most often presents during this episode number.
The ACP guideline recommends colonoscopy be performed this many weeks after an episode of complicated diverticulitis
What is 6 weeks?
In a study, the 5-year recurrence rate after elective sigmoidectomy was 15%, versus this much higher percentage in patients treated without surgery.
What is 61%?