№ 9Gastroenterology11 min read
Diverticulosis, diverticulitis
1. Big picture
Diverticulosis means the presence of diverticula in the colon, usually asymptomatic. Diverticulitis means inflammation/infection of a diverticulum, usually presenting with left lower quadrant abdominal pain, fever, and raised inflammatory markers.
The examiner wants you to distinguish:
| Condition | Core idea | Classic exam pattern |
|---|---|---|
| Diverticulosis | Diverticula are present but not inflamed | Elderly patient, often asymptomatic; may cause painless lower GI bleeding |
| Diverticular bleeding | Erosion of vessel near diverticulum | Sudden painless hematochezia |
| Diverticulitis | Inflamed or microperforated diverticulum | Left lower quadrant pain + fever + leukocytosis/CRP |
| Complicated diverticulitis | Abscess, perforation, fistula, obstruction, peritonitis | Sepsis, guarding, abscess on CT, fecaluria/pneumaturia |
The sigmoid colon is the most common site of colonic diverticulosis in Western populations and in the attached exam question file.
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