Diverticulitis is an inflammation and infection of outpouchings in the colon, commonly caused by trapped fecal material and bacteria, with contributing risk factors including a low fiber diet, obesity, and age over 50. Symptoms include abdominal pain, fever, and changes in bowel habits, while diagnostic evaluations involve imaging and lab tests. Treatment involves dietary management, antibiotics, pain relief, and, in severe cases, surgical intervention.

1. Diverticulitis

2. At the end of this lecture the students should be
able to:----
• Definition
• Pathophysiology
• Epidemiology
• Clinical presentation
• Differential
• Imaging
• Laboratory
• Treatment
• Reasons for surgery
Learning objectives

3. Diverticulitis
• Many people have small pouches in their
colons that bulge outward through weak
spots, like an inner tube that pokes
through weak places in a tire. Each pouch
is called a diverticulum (pl. diverticula).
• Usually 5-10mm in size

4. Definition
• Diverticulitis is out pouching of the
mucosal lining of the GIT that is inflammed
and infection caused by trapped fecal
material and bacteria, commonly in the
colon

5. 5

6. Causes and risk factors
• Obesity
• Low fiber diet
• Certain medication (corticosteroids, NSAIDs)
• Age – more than 50 yrs
• Spasm or straining
• Smoking
• Diet in high meat
6

7. • Heavy alcohol use
• Lack of exercise
• Low vitamin D level
• Hereditary

8. Pathophysiology
Lack of fiber in diet or any other risk factor
Weakness in the portion of colonic mucosa &
submucosa can lead to herniation
Raised intracolonic pressure in area of colon
Segmentation of colon occur due to increased pressure

9. Chamber creation with closed ends
Imbalance in mycosis, elastin, and collegen
Outpouching of intestinal lining

10. Pathophysiology

11. Sign and Symptom
• Abdominal pain (worsens with movement,
coughing, or straining)
• Cramping
• Low grade fever
• Constipation
• Episode of diarrhea
• Nausea and vomiting

12. • Abdominal distention
• Occult bleeding

13. Diagnostic evaluation
• Medical History
• Physical/digital exam of the rectum
• X-rays
• Barium enema
• Ct scan
• Sigmoidoscopy or colonoscopy
• Blood test
• Guiaic testing of stool
13

15. Complications
• Bleeding
• Abscess, Perforation & Peritonitis
• Fistula
• Intestinal obstruction
15

16. Treatment of Diverticular
Disease
• Collaborative management
–Diet
 High fiber diet
 Fluid intake of 2500-3000ml/day
 Avoids nuts and seeds that can trapped in
diverticula
–Bed rest
–NPO, then clear liquids to rest the colon
16

17. –Antibiotics (ciprofloxacin, metronidazole,
doxycycline, cephalexine)
–Analgesic (aspirin, ibuprofen, naproxen)
–Blood transfusion if needed
–Bulk forming laxatives
–NG tube insertion to relieve distention
–Weight management

18. Surgical management
• One stage resection: resection of inflamed
area is excised and end to end
anastomosis is done
• Hartmann procedure (multistage):
resection of the colon followed by
colostomy creation and then distal stump
is swen

19. Nursing management
• Impaired tissue integrity related to colon
obstruction
• Acute pain related to out pouching colon
and abdominal contraction
• Anxiety related to surgical procedure
• Risk for nutritional imbalance: less than
body requirement related to impaired
nutritional absorption

20. SUMMARY
In this class we discussed the :-
• Definition of diverticulitis
• Epidemiology of diverticulitis
• Pathophysiology of diverticulitis
• Clinical presentation of diverticulitis
• Investigation of diverticulitis
• Treatment of diverticulitis

21. BIBLIOGRAPHY
• Black, J.M. & Hawks, J.H. (2009). Medical-Surgical
Nursing: Clinical Management for Positive Outcomes
(8th ed.). Philadelphia: Elsevier/Saunders.
• Smeltzer, S.C., Bare, B.G., Hinkle, J.L., & Cheever,
K.H. (2010). Brunner & Suddarth’s Textbook of
Medical-Surgical Nursing (12th ed.). Philadelphia:
Lippincott Williams & Wilkins.
• Roberts, D. (Ed.). (2008). Medical–Surgical Nursing
Review Questions (2nd ed.). Pitman, NJ: Academy
of Medical Surgical Nurses.

22. Thank you!!!