Emergency Medicine Updates: Acute Diverticulitis
Authors: Brit Long, Jessie Werner, Michael Gottlieb
Published in: American Journal of Emergency Medicine, 2023 November 6
Conclusions:
Keeping abreast of current literature and guidelines can enhance the management of patients with acute diverticulitis in the emergency setting.
Discussion:
- Diverticulitis, a complication of diverticulosis, typically affects the sigmoid and descending colon in Western populations.
- Common symptoms and signs include abdominal pain, particularly in the left lower quadrant, change in bowel habits, and fever.
- Laboratory investigations may reveal leukocytosis or raised C-reactive protein levels.
- Imaging modalities for diagnosis include CT of the abdomen and pelvis with intravenous contrast, MRI, or ultrasound, though CT findings are often used in most classification systems.
- While most cases of diverticulitis are uncomplicated, complications can occur in up to 25% of patients.
- Management of complicated diverticulitis involves antibiotics and surgical consultation.
- In selected cases of uncomplicated diverticulitis, antibiotics may not be necessary.
- Patients suitable for non-antibiotic supportive care should be stable, have controlled pain, tolerate oral intake, follow up reliably, have no complications, and should not be immunocompromised or have severe comorbidities.