1 / 15

Diverticulitis

Diverticulitis. Fariba Jafari. Definition. Outpouchings of the colon Located at sites where blood vessels enter the colonic wall Inflamed as a result of obstruction by feces or hardened mucus or of mucosal erosion  localized perforation= diverticulitis. Associated Risk Factors.

kelli
Télécharger la présentation

Diverticulitis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Diverticulitis Fariba Jafari

  2. Definition • Outpouchings of the colon • Located at sites where blood vessels enter the colonic wall • Inflamed as a result of obstruction by feces or hardened mucus or of mucosal erosion localized perforation= diverticulitis

  3. Associated Risk Factors • Decreased physical activity • Intake of non-steroidal anti-inflammatory drugs (NSAID) • Smoking • Constipation from any cause • Incidence increases with age. • Diet has been associated with the emergence of this disease.

  4. Low-residue diet constipation  lead to increased intraluminal pressure in the large bowel • High pressure zones or areas of segmentation may develop (sigmoid colon), and diverticula begin to protrude at these locations • Microperforation of thin walled diverticulum widespread contamination with fecal organisms may ensue

  5. Saint’s triad • Cholelithiasis, diverticulitis, and hiatal hernia frequently occur together.

  6. Characteristic Findings • Abdominal pain • LLQ tenderness • Irregular bowel habits • Fever

  7. Physical Examination • Uncomplicated: LLQ tenderness, possible mass, bleeding (uncommon), localized inflammation, • Complicated: mass, evidence of fistula, ambdominal distention, abdominal tenderness, marked in cases of free perforation, hypotension; bleeding

  8. 2 courses • Mild: outpatient basis. Liquid diet, oral antibiotics • If not: hospitalize patient. NPO. IV antibiotics. CT with contrast.

  9. What now? • Symptoms resolve: colonoscopy or contrast study • Recur: surgical treatment Surgical • 20% of patients with diverticulitis require surgical treatment.

  10. Obstruction • Perform diagnostic imaging • Small bowel: high-grade, low-grade • Large bowel: cecal distention

  11. Abscess • Perform diagnostic imaging • Small abscess • Large abscess

  12. Fistula • Signaled by fecaluria and pneumaturia • Diagnostic imagingbladder air • Treat medically • Resect colon and fistula in one-stage procedure

  13. Free Perforation • SURGICAL TREATMENT!! • Hinchey Stage III & IV • To the WEB

  14. Bleeding (lower GI) • Massive • Transfusions • Angiography • If + superselective embolization • If - observe patient, RBC scanning. • Moderate • Observe patient • Colonoscopy

More Related