Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • left lower quadrant abdominal pain
  • leukocytosis
  • fever
  • rectal bleeding

Other diagnostic factors

  • guarding in left lower quadrant
  • tenderness in left lower quadrant
  • bloating
  • constipation
  • pelvic tenderness on digital rectal exam
  • diffuse abdominal tenderness
  • diarrhea
  • palpable abdominal mass

Risk factors

  • low dietary fiber
  • Western diet
  • age >50 years
  • obesity (BMI >30)
  • Nonsteroidal anti-inflammatory drug (NSAID) use

Diagnostic investigations

1st investigations to order

  • CBC with differential
  • CXR
  • CT scan of abdomen
Full details

Investigations to consider

  • abdominal x-ray
  • abdominal ultrasound (graded-compression)
  • contrast enema
  • colonoscopy
  • sigmoidoscopy
  • angiogram
  • isotope-labeled RBC nuclear scan
  • diagnostic laparoscopy/exploratory laparotomy
  • blood culture
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Senior Lecturer & Consultant in Colorectal Surgery

Academic Surgical Unit

National Centre for Bowel Research & Surgical Innovation (NCBRSI)

Blizard Institute

Barts and The London School of Medicine and Dentistry

The Royal London Hospital

Queen Mary, University of London

London

UK

Disclosures

MAT declares that he has no competing interests.

Clinical Research Fellow and Specialty Registrar in Surgery

National Centre for Bowel Research & Surgical Innovation

Blizard Institute

Barts and The London School of Medicine and Dentistry

Queen Mary, University of London

London

UK

Disclosures

KL has received funding for a research fellowship from the David Johnston Fellowship through the Royal College of Surgeons of England.

Dr Mohamed A. Thaha and Ms Kathryn Lynes would like to gratefully acknowledge Prof Norman S. Williams and Dr Abbasi Akhtar, the previous contributors to this monograph. NSW is an author of a reference cited in this monograph. AA declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Medicine

Chief of Clinical Gastroenterology and Hepatology

University of Texas Medical Branch

Galveston

TX

Disclosures

NS declares that he has no competing interests.

Clinic of digestive and endocrine surgery

University Hospital

Nantes

France

Disclosures

NR declares that he has no competing interests.

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