| Abstract: |
This article presents a case vignette of a patient with diverticulitis, with the evidence supporting various strategies for patient diagnosis and treatment. The author discusses formal guidelines for this disorder and presents clinical recommendations. In this case, a previously healthy 45-year-old man presents with severe lower abdominal pain on the left side, which had started 36 hours earlier. Symptoms include nausea, anorexia, and vomiting associated with any oral intake. The patient's temperature is 38.5 degrees Celsius and his heart rate is 110 beats per minute. He has abdominal tenderness on the left side, without peritoneal signs. The author reviews the terms diverticulosis and diverticular disease, the causes of colonic diverticular disease, the pathogenesis of diverticulitis, complications associated with diverticulitis, including in immunocompromised patients, diagnosis and staging, the use of imaging and endoscopy tests to confirm diagnosis, the decision to hospitalize a patient for diverticulitis, percutaneous drainage, operative intervention, and laparoscopic procedures. The author includes a section about areas of uncertainty; the section outlines recommended areas for future research. 5 figures. 1 table. 49 references. |