Diverticulitis | Acute and Chronic Diverticulitis | Diagnosis and Treatment .
Diverticulitis
- Inflammation is the commonest complication of the diverticulosis coli.
- The chance increases as the age advances.
- This condition is hardly seen above the age of 40yrs.
- Diverticulitis is more common in patients with widespread diverticulosis.
- Diverticula’s remain filled with colonic contents. If an inspissated fecal plug obstructs the neck of the diverticulum, proliferation of ever present bacteria produces inflammation within the diverticulum.
- If the obstructing plug moves away the content of the diverticulum is discharged into the colon and inflammation subsides.
- If the obstructing plug remains in place, inflammation spreads to the peri-diverticular tissue.
- Extension occurs longitudinally. Posted by http://signs-causes-treatment-prevention.blogspot.com Prevention And Detection Of Diseases At An Early Stage When The First Signs To Get The Most Effective Treatment.
- In the beginning diverticulitis starts in a single diverticulum and gradually spreads to the other.
- Clinical presentation can be acute or chronic. Sigmoid diverticulitis resembles that of appendicitis and is often called as left sided appendicitis.
- Pain is the most important symptom. It is mild to moderate and occasionally severe.
- Low grade fever and leucocytosis is common.
- On examination, tenderness on the left quadrant is quite diagnostic.
- Sigmoidoscopy and barium enema confirms the diagnosis.
- Preventive- condition can be reversed by adaptation of a high residue diet, supplemented by bulk-producing laxatives.
- Medical treatment- parentral fluids, naso-gastric suction, broad spectrum antibiotics and drugs to relieve pain are given. Posted by http://signs-causes-treatment-prevention.blogspot.com Prevention And Detection Of Diseases At An Early Stage When The First Signs To Get The Most Effective Treatment.
- Surgical treatment- disease without complication require sigmoid myotomy. Other cases require resective surgery.
- The inflammation is usually localized to the area adjacent to the perforation, thus forming a peri-colic abscess.
- Occasionally the peri-colic abscess burst into the peritoneal cavity causing peritonitis.
- Treatment for Perforation and peritonitis
- With localized peritonitis medical treatment is justified with careful watch. When acute inflammation has completely subsided, elective surgery should be called for. In case of acute generalized peritonitis emergency operation becomes mandatory.
- Partial obstruction may be due to inflammation, spasm and edema with an element of paralytic ileus.
- Complete obstruction may occur due to repeated episodes of inflammation of diverticula.
- Treatment for Obstruction
- Main treatment is immediate transverse colostomy and primary resection of the bowel with anastomosis.
- Internal fistulas may occur in 5% of cases between the involved segment of colon and adjacent organs e.g. urinary bladder, ileum, uterus, vagina and ureter.
- Treatment for Fistula
- The diseased colon is resected with primary anastomosis. Supra-pubic drainage is given.
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