A 60-year-old female presented with acute cramping pain in her lower left quadrant and diminished appetite. Her temperature was 37.6°C. Additional laboratory tests showed a raised white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. A CT colonography revealed colonic wall thickening, diverticula, and pericolic abscesses, confirming the diagnosis of acute diverticulitis. Treatment options included oral antibiotics for mild cases or intravenous antibiotics and bowel rest with admission for severe cases.

1. Acute diverticulitis
CASE VIGNETTE : B
PRESENTER II : FATIMA AL-AWADH

2. Case
• 60 year old female.
• Acute cramping pain in LLQ.
• Diminished appetite.
• Body temperature 37.6 ℃ .

3. Questions
3. Which additional laboratory studies
and imaging procedures do you request
to come to a definitive diagnosis?
4. Which treatment options do you
consider?

4. Investigations
Blood Tests
- CBC :
Polymorphonuclear
leukocytosis.
- ESR and CRP:
Raised

5. Investigations
CT colonography
- Findings:
- Colonic wall thickening.
- Diverticula.
- Pericolic abscesses.
- Diagnostic (95% sensitivity and
specificity)
- Differentiates malignancy.

6. Investigations
Ultrasonography
- More available and cheaper.
- Less sensitive than CT.
- Findings :
- Thickened bowel.
- Pericolic collections.

7. Treatment
AcuteDiverticulitis
Mild Oral antibiotic
Ciprofloxacin and
Metronidazole
Sever
Admission
Bowel rest
I.V. fluids
I.V. antibiotics

8. Reference
Kumar and Clack, Clinical
Medicine, Eighth Edition

9. The End