Diverticulitis physical examination: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
Diverticulitis diagnosis depends on taking a proper [[History & Symptoms|history]] and doing [[physical examination]]. The known [[diagnostic criteria]] for diverticulitis includes [[abdominal tenderness]] especially in the [[Left lower quadrant abdominal pain resident survival guide|left lower quadrant]], [[leukocytosis]] and CT scan findings | Diverticulitis diagnosis depends on taking a proper [[History & Symptoms|history]] and doing the [[physical examination]]. The known [[diagnostic criteria]] for diverticulitis includes [[abdominal tenderness]] especially in the [[Left lower quadrant abdominal pain resident survival guide|left lower quadrant]], [[leukocytosis]] and CT scan findings help in [[disease]] confirmation. [[Fever]] is common in diverticulitis patients.The abdominal examination will reveal [[tenderness]], [[decreased bowel sounds]] and palpable [[mass]] may be felt. In some patients, [[genitourinary]] signs of [[cystitis]] would occur due to [[bladder]] [[irritation]].<ref name="pmid3536213">{{cite journal| author=Thompson WG, Patel DG| title=Clinical picture of diverticular disease of the colon. | journal=Clin Gastroenterol | year= 1986 | volume= 15 | issue= 4 | pages= 903-16 | pmid=3536213 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3536213 }} </ref> | ||
==Physical Examination== | ==Physical Examination== | ||
| Line 12: | Line 12: | ||
*[[Abdominal pain]] and left quadrant [[tenderness]] | *[[Abdominal pain]] and left quadrant [[tenderness]] | ||
*[[Leukocytosis]] in the lab findings. | *[[Leukocytosis]] in the lab findings. | ||
*CT scan confirms the disease. It usually shows dilated loops, extra-colonic air in case of [[fistula]], [[abscess]] and air fluid level. | *CT scan confirms the disease. It usually shows dilated loops, the extra-colonic air in case of [[fistula]], [[abscess]] and air fluid level. | ||
===Appearance of the patient=== | ===Appearance of the patient=== | ||
| Line 23: | Line 23: | ||
===Abdomen=== | ===Abdomen=== | ||
Abdominal examination in the diverticulitis cases shows the following:<ref name="pmid10566700">{{cite journal| author=Stollman NH, Raskin JB| title=Diagnosis and management of diverticular disease of the colon in adults. Ad Hoc Practice Parameters Committee of the American College of Gastroenterology. | journal=Am J Gastroenterol | year= 1999 | volume= 94 | issue= 11 | pages= 3110-21 | pmid=10566700 | doi=10.1111/j.1572-0241.1999.01501.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10566700 }} </ref> | Abdominal examination in the diverticulitis cases shows the following:<ref name="pmid10566700">{{cite journal| author=Stollman NH, Raskin JB| title=Diagnosis and management of diverticular disease of the colon in adults. Ad Hoc Practice Parameters Committee of the American College of Gastroenterology. | journal=Am J Gastroenterol | year= 1999 | volume= 94 | issue= 11 | pages= 3110-21 | pmid=10566700 | doi=10.1111/j.1572-0241.1999.01501.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10566700 }} </ref> | ||
*[[Abdominal tenderness]] in the left lower quadrant. It is rare to occur | *[[Abdominal tenderness]] in the left lower quadrant. It is rare to occur on the right side but it could happen. | ||
*[[Abdominal guarding|Guarding]] or [[rebound tenderness]] may be present. | *[[Abdominal guarding|Guarding]] or [[rebound tenderness]] may be present. | ||
* | *A palpable [[mass]] may be felt. | ||
*[[Bowel sounds]]: | *[[Bowel sounds]]: | ||
**Most often decreased | **Most often decreased | ||
**Normal in the mild cases | **Normal in the mild cases | ||
**Increased in cases of [[intestinal obstruction]] | **Increased in cases of [[intestinal obstruction]] | ||
*Mass may be palpable | *Mass may be palpable on [[rectal examination]] | ||
===Genitourinary=== | ===Genitourinary=== | ||
* As a result of the colonic [[inflammation]], [[Urinary bladder|bladder]] [[inflammation]] may occur in small percentage of the patients. Clinical manifestations of [[cystitis]] will appear.<ref name="pmid13903556">{{cite journal| author=HAFNER CD, PONKA JL, BRUSH BE| title=Genitourinary manifestations of diverticulitis of the colon. A study of 500 cases. | journal=JAMA | year= 1962 | volume= 179 | issue= | pages= 76-8 | pmid=13903556 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13903556 }} </ref> | * As a result of the colonic [[inflammation]], [[Urinary bladder|bladder]] [[inflammation]] may occur in a small percentage of the patients. Clinical manifestations of [[cystitis]] will appear.<ref name="pmid13903556">{{cite journal| author=HAFNER CD, PONKA JL, BRUSH BE| title=Genitourinary manifestations of diverticulitis of the colon. A study of 500 cases. | journal=JAMA | year= 1962 | volume= 179 | issue= | pages= 76-8 | pmid=13903556 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13903556 }} </ref> | ||
==References== | ==References== | ||
Revision as of 18:04, 28 July 2017
|
Diverticulitis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Diverticulitis physical examination On the Web |
|
American Roentgen Ray Society Images of Diverticulitis physical examination |
|
Risk calculators and risk factors for Diverticulitis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Diverticulitis diagnosis depends on taking a proper history and doing the physical examination. The known diagnostic criteria for diverticulitis includes abdominal tenderness especially in the left lower quadrant, leukocytosis and CT scan findings help in disease confirmation. Fever is common in diverticulitis patients.The abdominal examination will reveal tenderness, decreased bowel sounds and palpable mass may be felt. In some patients, genitourinary signs of cystitis would occur due to bladder irritation.[1]
Physical Examination
Diagnostic criteria
Patients with acute diverticulitis usually present with the following:[1]
- Abdominal pain and left quadrant tenderness
- Leukocytosis in the lab findings.
- CT scan confirms the disease. It usually shows dilated loops, the extra-colonic air in case of fistula, abscess and air fluid level.
Appearance of the patient
Vital signs
Abdomen
Abdominal examination in the diverticulitis cases shows the following:[2]
- Abdominal tenderness in the left lower quadrant. It is rare to occur on the right side but it could happen.
- Guarding or rebound tenderness may be present.
- A palpable mass may be felt.
- Bowel sounds:
- Most often decreased
- Normal in the mild cases
- Increased in cases of intestinal obstruction
- Mass may be palpable on rectal examination
Genitourinary
- As a result of the colonic inflammation, bladder inflammation may occur in a small percentage of the patients. Clinical manifestations of cystitis will appear.[3]
References
- ↑ 1.0 1.1 Thompson WG, Patel DG (1986). "Clinical picture of diverticular disease of the colon". Clin Gastroenterol. 15 (4): 903–16. PMID 3536213.
- ↑ Stollman NH, Raskin JB (1999). "Diagnosis and management of diverticular disease of the colon in adults. Ad Hoc Practice Parameters Committee of the American College of Gastroenterology". Am J Gastroenterol. 94 (11): 3110–21. doi:10.1111/j.1572-0241.1999.01501.x. PMID 10566700.
- ↑ HAFNER CD, PONKA JL, BRUSH BE (1962). "Genitourinary manifestations of diverticulitis of the colon. A study of 500 cases". JAMA. 179: 76–8. PMID 13903556.