Last reviewed:September 2019
Last updated:October  2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk 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 examination
  • diffuse abdominal tenderness
  • diarrhoea
  • palpable abdominal mass

Risk factors

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

Diagnostic investigations

Investigations to consider

  • abdominal x-ray
  • CT scan of abdomen
  • abdominal ultrasound (graded-compression)
  • chest x-ray
  • contrast enema
  • colonoscopy
  • sigmoidoscopy
  • angiogram
  • isotope-labelled red blood cell nuclear scan
  • diagnostic laparoscopy/exploratory laparotomy
  • blood culture
Full details

Treatment algorithm

Contributors

Senior Lecturer & Lead Consultant in Colorectal Surgery

National Bowel Research Centre

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 Lecturer in Colorectal Surgery

Blizard Institute

Barts and The London School of Medicine and Dentistry

The Royal London Hospital

Queen Mary, University of London

London

UK

Disclosures

EC has received honoraria for teaching, and acts as a consultant for Laborie Medical Management Systems.

Dr Mohamed A. Thaha and Dr Emma Carrington would like to gratefully acknowledge Ms Kathryn Lynes, Prof Norman S. Williams, and Dr Abbasi Akhtar, the previous contributors to this topic.

Peer reviewersVIEW 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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