Download Diverticular disease of the colon

Diverticular disease of the
colon
Presented by J. Karl Pineda
Pathophysiology

Diverticular disease may involve any part of
the GI tract. Typically acquired, diverticular
disease may be congenital, such as Meckel
iliac diverticulum (although this is rare).
Diverticula are herniations of the mucosa and
submucosa or the entire wall thickness
through the muscularis, as seen in congenital
diverticula. The sigmoid is the most
commonly affected (95-98%)
Pathophysiology
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
Diverticular disease also can involve the
descending, ascending, and transverse colon
as well as the jejunum, ileum, and duodenum
The penetration of fecal matter through the
thin-walled diverticula causes inflamation and
abscess formation in the tissue surrounding
the colon.
Signs and Symptoms

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Constipation and diarrhea accompanied by
pain in the lower-left quadrant
Flatus, anorexia, and nausea
Abdominal distention, low grade fever,
vomiting, and blood in the stool
Diagnostic Tests

CT scan with oral contrast
Diagnostic Test
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
X ray
Thumbprinting
on left mid
quadrant
Diagnostic Tests
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CBC
Urinalysis
Fecal occult blood tests
Barium enema determine narrowing or
obstruction of the lumen
Colonoscopy
If patient has acute diverticulitis barium
enmas are contraindicated (perforation &
peritonitis)
Medical Management
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Low residue diet
Stool softners
Bed rests
Sulfa drugs
Analgesics
GoLYTELY in elective surgery
Hartmann’s procedure
Medications

Laxatives

Antibiotics
Nursing Intervention
Interventions
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IV fluids and an NG tube for first few day post
operatively if bowel activity has not retuned
PT teaching
Comfort measures and the assessment of
pain
Teach patient colonoscopy care when patient
is free of pain
Prognosis

Good with 30% of patients needing bowel
resection of the affected part in acute case to
reduce mortality and morbidity