Gastroenterology · UKMLA & AKT
Acute diverticulitis
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise acute diverticulitis — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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