Term
| Diverticula are most commonly found: |
|
Definition
| in the sigmoid and descending colon |
|
|
Term
| what is the most common cause of lower GI bleed in the elderly: |
|
Definition
| diverticular bleeding; must RO colon CA |
|
|
Term
|
Definition
| usually follows many yrs of a diet lacking fiber, develop in weak spots of the colon wall + high pressure of contraction against hard stools lacking fiber |
|
|
Term
| etiology of diverticulitis: |
|
Definition
| trapped fecal material and bacteria in the diverticula |
|
|
Term
| 4 risk factors for diverticula: |
|
Definition
1. low fiber diet over many yrs
2. >60yrs
3. obesity
4. lack of exercise |
|
|
Term
|
Definition
1. usually asx
2. LLQ pain relieved w BM
3. alternating diarrhea/constipation |
|
|
Term
|
Definition
1. LLQ pain, worse c movement/coughing, etc.
2. low grade Fvr/N/V
3.chronic constipation c episodes of diarrhea
4. abd distinsion
5. occult bleeding |
|
|
Term
| chronic constipation assoc w diverticulitis is caused by: |
|
Definition
|
|
Term
| Fvr/N/V in diverticulitis is caused by: |
|
Definition
| inflammation/infection stimulates chemoreceptors>emetic center in medulla activated via vagal nerve afferents |
|
|
Term
| development of abcess or perforation of diverticula can lead to: |
|
Definition
|
|
Term
| abdominal distension described in diverticulitis is caused by: |
|
Definition
|
|
Term
| occult bleeding in diverticula are caused by: |
|
Definition
| perforation of the diverticula |
|
|
Term
| there is minimal need for phys exam if pt has hx of: |
|
Definition
|
|
Term
| describe diverticula in abd x-ray: |
|
Definition
| thumbprints, free air if perforated |
|
|
Term
| which imaging study is contraindicated during an acute attack of diverticulitis: |
|
Definition
| barium enema, colonoscopy, sigmoidoscopy |
|
|
Term
| imaging that is diagnostic for diverticulitis: |
|
Definition
|
|
Term
| describe the fistula complication of diverticulitis: |
|
Definition
| inflammation causes tract to develop btwn diverticula and bladder |
|
|
Term
| Tx/management of diverticulitis: |
|
Definition
1. bedrest
2. NPO
3. IV
4. Abx
5. analgesics/antispasmatics
6. NG tube |
|
|
Term
| what indicates severe diverticulitis: |
|
Definition
1. high fvr/leukocytosis
2. inability to tolerate fluids
3. increasing pain
4. comorbid dz |
|
|
Term
| 2nd serious infection w diverticulitis requires: |
|
Definition
| admit w colon resection consideration |
|
|
Term
| management of the diverticulitis: |
|
Definition
1. high fiber intake
2. 2500-3000ml fluid/day
3. weight loss to reduce intra-abdominal pressure |
|
|
