Last reviewed: 13 Apr 2021
Last updated: 22 Feb 2021

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
  • diet rich in salt, meat, and sugar
  • age >50 years
  • obesity (BMI >30)
  • nonsteroidal 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-labeled red blood cell nuclear scan
  • diagnostic laparoscopy/exploratory laparotomy

Treatment algorithm

Contributors

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 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.

Use of this content is subject to our disclaimer