Diverticulitis

• Diverticulum are most often found in the sigmoid colon. This is most likely because of the high pressure zone.
• The sigmoid colon has to work more to empty its self with a highly refined diet
• The diverticulum can be quiet at first, but then when obstruction or proliferation of bacteria begin to start. This might remind you of meckles or appendicitis
• This is the smallest of obstruction that leads to sequestration

• Diverticulitis - this can spread
  Blood supply is compromised, swelling occurs
• It is the most common cause of free air in the abdomen *

  • These will not get golf ball size

  • The wall is thin and there is opportunity for rupture

    • If gas is released it will be seen easily in the upper right quadrant

• This can occur form the esophagus to the sigmoid colon

  • More often the sigmoid

  • Symptoms will be bad enough to go to the hospital

  • May be on antibiotic therapy

  • LLQ pain **

  • Most common cause of free air in the abdomen is a RUPTURED DIVERTICULUM

• MANAGEMENT

  • Early recognition - send to hospital

  • Observation and prevention is what you can assist with.

  • Once the out pocketing occurs you have it forever

  • Anything with small seeds - ELEMINATE from diet

    • No popcorn, or peanut shell

  • The older the patient the more often the deconditioning of the bowel may occur - so you may create a high grade obstruction if there is a significant increase in fiber too quickly

• Why does fiber work?

  • It increases the fecal bulk

Category: Surgery Notes