Diverticular disease

Acute diverticulitis typically presents with left lower quadrant abdominal pain, often together with fever and leukocytosis.

Laboratory test results are not consistently reliable and computed tomography scan is the imaging modality of choice for acute diverticulitis.

Complications of diverticulitis include perforation, abscess, peritonitis, fistula, stricture, obstruction, or chronic inflammation.

Treatment for acute diverticulitis may include bowel rest, analgesics, antibiotics, and surgical intervention.

Diverticulosis is the presence of diverticula without symptoms. It is usually an incidental finding and requires no treatment, although patients may benefit from dietary changes to reduce the risk of progression to diverticulitis.

Colonic diverticulosis refers to herniation of the mucosa and submucosa through the muscular layer of the colonic wall. Diverticulosis is the presence of diverticula without symptoms.[1]National Institute for Health and Care Excellence (UK). Diverticular disease: diagnosis and management. Nov 2019 [internet publication]. https://www.nice.org.uk/guidance/ng147 ​ Diverticulitis indicates inflammation of a diverticulum or diverticula; it is described as "complicated" where there is acute inflammation with an abscess, phlegmon, fistula, obstruction, or perforation, with or without peritonitis, or "uncomplicated" where there is acute onset of inflammation but without any of these complications.[2]Peery AF. Management of colonic diverticulitis. BMJ. 2021 Mar 24;372:n72. http://www.ncbi.nlm.nih.gov/pubmed/33762260?tool=bestpractice.com [3]Hall J, Hardiman K, Lee S, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the treatment of left-sided colonic diverticulitis. Dis Colon Rectum. 2020 Jun;63(6):728-47. https://journals.lww.com/dcrjournal/Fulltext/2020/06000/The_American_Society_of_Colon_and_Rectal_Surgeons.6.aspx http://www.ncbi.nlm.nih.gov/pubmed/32384404?tool=bestpractice.com ​​ Complications of acute diverticulitis most commonly include abscess, perforation, peritonitis, fistula formation, and obstruction, while segmental colitis, and chronic/smoldering diverticulitis, can also occur.