Gastroenterology · UKMLA & AKT
Acute diverticulitis
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Left iliac fossa pain - constant (not colicky), severe; starts centrally then localises to left lower quadrant ('left-sided appendicitis')
- Fever - low-grade in uncomplicated disease; high fever suggests complication
- Change in bowel habit - diarrhoea or constipation
- Localised LIF tenderness on palpation; palpable mass if abscess has formed
- Dysuria/urinary frequency - if inflamed sigmoid is adjacent to bladder
- Suspect complicated diverticulitis if:
- Abdominal rigidity, guarding, rebound tenderness - possible perforation/peritonitis
Acute diverticulitis causes severe LIF pain, fever, and raised inflammatory markers - this distinguishes it from constipation (no fever, normal obs) and UTI (no LIF mass, no guarding). In an elderly confused patient with a LIF fullness and normal observations, constipation is far more likely than diverticulitis.
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