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
- diet rich in salt, meat, and sugar
- age >50 years
- obesity (BMI >30)
- non-steroidal anti-inflammatory drug (NSAID) use
Diagnostic investigations
Investigations to consider
- CT scan of abdomen
- blood culture
- abdominal x-ray
- abdominal ultrasound (graded-compression)
- abdominal MRI scan
- chest x-ray
- contrast enema
- colonoscopy
- sigmoidoscopy
- angiogram
- isotope-labelled red blood cell nuclear scan
- diagnostic laparoscopy/exploratory laparotomy
Treatment algorithm
Contributors
Authors
Senior Lecturer & Consultant in Colorectal Surgery
National Bowel Research Centre
Blizard Institute
Barts and The London School of Medicine and Dentistry
Queen Mary University of London
The Royal London Hospital
Barts Health NHS Trust
London
UK
Disclosures
MAT declares that he has no competing interests.
International Senior Fellow in Colorectal Surgery
The Royal London Hospital
Barts Health NHS Trust
London
UK
Disclosures
JDJ declares that he has no competing interests.
Dr Mohamed A. Thaha and Dr Jayan D. Jayasinghe would like to gratefully acknowledge Dr Emma Carrington, Ms Kathryn Lynes, Professor Norman S. Williams, and Dr Abbasi Akhtar, the previous contributors to this topic.
Disclosures
EC has received honoraria for teaching, and acts as a consultant for Laborie Medical Management Systems. KL has received funding for a research fellowship from the David Johnston Fellowship through the Royal College of Surgeons of England. NSW is an author of a reference cited in this topic. AA declares that he has no competing interests.
Peer reviewers
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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