Diverticular diseases of the colon

This chapter discusses the background, prevention, diagnosis, treatment, and prognosis for diverticular diseases of the colon. The key factors from clinical history leading to a diagnosis of acute diverticulitis: older age, prior history of diverticulitis, localization of symptoms in the left lower quadrant of the abdomen, aggravation of pain on motion, and absence of vomiting. Acute diverticulitis usually presents with left lower quadrant abdominal pain, tenderness, fullness or mass, and fever; there may be accompanying diarrhea but no bleeding. The most useful diagnostic test is lower gastrointestinal (GI) imaging, usually CT scan, to demonstrate diverticula and extraluminal extravasation with or without abscess. A common diagnostic error in patients with recurrent diverticulitis, especially if they happen to have fistulization or extraintestinal manifestations, is to attribute the symptoms and signs to Crohn’s disease.