-          complications of diverticular disease of the colon - a disease characterized by the appearance of diverticula (wall protrusions) in the colon, mostly in the sigmoid region

-          diverticulosis has two types of complications, both classified as acute abdomen:

1.) inflamation

a) divertikulitis – perikolitis – parakolic abscess (circumscribed peritonitis)

b) disffuse peritonitis – purulent (from egress) or stercoral (from perforation)

c) stenosis and obstruction (ileus)

d) fistula (mainly to the bladder or vagina)

2.) bleeding

a.) small – anemisation

b.) big – hypovolemia

klinical manifestations and diagnosis

-          uncomplicated diverticulosis may be asymptomatic or manifest non-specifically (left abdominal pain, gas and stool disorders, dyspepsia)

-          manifestations of the complications:

1.) diverticulitis – pain in the left hypogastrium, nausea until vomiting, cessation of passing gas and stool, palpatory pain, resistance in the left lower abdomen, eventual signs of peritoneal irritation, ↑ T, ↑ HR, leu, CRP, FW

2.) obstruction – signs of the „low“ ileus

3.) fistula – pneumaturia and fekaluria, passage of gas and stool through the vagina

4.) bleeding – anemia, enteroragia

-          the main importance of diagnostic imaging methods is irrigography, CT and ultrasound to examine wall morphology, coloscopy, angiography for bleeding

treatment

-          surgical treatment is indicated in the case of complications as:

1.) acute – abscess, peritonitis, ileus, bleeding – resekction, stomia, drainage

2.) elective – fistulas, stenosis – resekction, colomyotomia

-          abscesses can also be treated by puncture under CT or ultrasound control, bleeding can be embolised