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Diverticulosis and Diverticulitis Assessment

Diver-lumpy and Diver-on-fire with Assess-man
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A patient with diverticula, outpouchings found in the descending, sigmoid colon, is said to have diverticulosis. Diverticula are common in the older adult and may never produce symptoms or complications. However, when the outpouchings become inflamed, the condition is called diverticulitis. If left untreated, diverticulitis can lead to perforation of the intestine and can cause peritonitis. Clinical manifestations of diverticulitis include lower left-side abdominal pain, abdominal distention, flatulence, fever, rectal bleeding, and constipation or diarrhea.
9 KEY FACTS
DIVERTICULOSIS
Outpouching
Outpouch

A patient with outpouchings, or diverticula, in their colon is said to have diverticulosis. This condition is likely related to low intake of dietary fiber and increased pressure in the colon needed to expel the small, low-bulk stool.  Diverticulosis is common in older adult patients, though it may never produce complications. Many patients with diverticulosis never have any symptoms.

DIVERTICULITIS
Inflamed Diverticula
Inflamed Diver

Inflammation of the diverticula, or outpouchings of the colon, is called diverticulitis. If left untreated, this condition can lead to perforation of the intestine and can cause peritonitis.

ASSESSMENT
Abdominal Pain
Abdominal Pain-bolt

Patients may report lower, left-sided abdominal pain and cramping. Though uncommon, right-sided abdominal pain may also occur.

Abdominal Distention
Abdomen Distended

Abdominal bloating and distention can occur if there is difficulty passing stool through the affected area of the colon.

Flatulence
Farting

Flatulence is a common finding in patients with diverticular disease.

Fever
Fever-beaver

Inflammation and infection of the diverticula seen in diverticulitis can produce a fever.

Rectal Bleeding
Rectum-rectangle Bleeding

Diverticula often contain small blood vessels. When these vessels rupture, diverticula will bleed, causing hematochezia, or bleeding from the rectum.

Alternating Constipation and Diarrhea
Corked Con-toilet and Toilet

Patients with diverticular disease initially experience chronic constipation and then diarrhea.

CONSIDERATIONS
Peritonitis
Parrot-toe-on-fire

If the diverticula become inflamed and rupture, peritonitis or inflammation of the peritoneum can develop. Hypovolemic shock can occur in patients with peritonitis, due to the large fluid shift from the vasculature into the abdominal cavity. Other lab results that may be indicative of an infection related to peritonitis are an elevated C-reactive protein level and leukocytosis with a shift to the left (increased number of immature neutrophils).

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