Acute Diverticulitis: A Case Study

He was able to tolerate PO earlier around 6am. but now denies having an appetite. Patient had very small bowel movement earlier this morning that was not normal for him. He has not passes has the morning. 'he is voiding well. Denies fevers, chills or night sweats. The pain is localized to the RLQ without radiation at this point. He has never had a colonoscopy.

diverticulitis. The patient has no diet regimen, which may be the likely cause of his

HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now

The patient complained of right lower quadrant pain and of feeling faint. Dr. O'Donnel documented a chief complaint, a brief history of present illness, and a systemic review of the gastrointestinal system and respiratory system. Dr. O'Donnel also documented a complete examination of all body systems, which included all required elements. Medical decision making was of moderate complexity.

The causes of diverticulitis are also thought to be due to internal pressure in the colon. It’s not completely understood what causes the diverticula to become inflamed and infected. The internal pressure of fecal matter in the diverticula can impair circulation; when circulation is reduced in the diverticula, the tissue can break down and sometimes the pouches can burst.

Patients present with left lower quadrant pain, reiterating the tendency for diverticulitis to affect the sigmoid colon in western countries. The pain can be constant or intermittent, and lack of appetite, or nausea and vomiting can be present. Physical examination of the abdomen reveals localized tenderness but frank rebound or guarding should be negative. Bowel sounds are frequently distant or depressed, if bowel sounds are very active an obstruction may be present, in mild cases the bowel sounds may be normal. The WBC may be elevated and the patient may present with a fever. Occasionally a palpable mass may be felt and may be very painful. Eating exacerbated the pain of left-sided diverticulitis and pain can be lessened with the passage of feces or flatus. Patients may complain of a feeling of being bloated.

L., Millan, M., Kreisler, E., & Jaurrieta, E. (2011). Currentstatus of the treatment of acute colonic diverticulitis: a systematic review.Colorectal Disease, 14(1). doi:10.1111/j.1463-1318.2011.02766.x

"Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon” (MedicineNet, 2010, para.1). Or at least that’s what MedicineNet.com states that it is. Sometimes what we find on the Internet isn’t as reliable as what we may think. Doing research and finding correct and reliable information is very important in the nursing practice. There is so much information available at our fingertips, but finding accurate information is sometimes a challenge and can be detrimental to patient care if the information found is inaccurate. The purpose of this assignment is to evaluate the validity of three health websites.

The symptoms include tenderness, cramps and pain in the lower abdomen, fever that are accompanied with chills, gas, a bloated feeling or stomach swelling, diarrhea or constipation, nausea, loss of appetite and rectum bleeding which is usually painless. It is evident that many people who are diagnosed with diverticular disease have little or no symptoms at all but those who do are recommended high-fiber diet plans or fiber supplements as treatment.

Sakeenah is 14 years old African american girl, she comes to the University of Michigan Pediatric Gastroenterology clinic on 5/22/2018 complaining of abdominal pain. She is accompanied mom and dad today and she provides the interval medical history, She states that the pain started month ago, epigastric, and occasionally radiate to right side, described as squeezing or burning pain. She states that the pain is on/off, in scale of 7-8/10, occur more in the morning. The pain lasts few hours several time a day. She feels that "food sits in my stomach and doesn't digest." Sakeenah states that pain is worse when she eating a grassy food, she stop eating it for a while and the pain seems

Pathophysiology: Diverticulitis, is characterized by inflamed diverticuli and increased luminal pressures that cause erosion of the bowel wall and thus microscopic or macroscopic perforation into the peritoneum. A localized abscess develops when the

A colonoscopy dated 09/28/2017 revealed a diverticulitis in the sigmoid colon and in the descending colon. The examination was otherwise normal.

Wilcox (2009) compared various types of diverticular syndromes and their treatments. He found out that the treatment for the asymptomatic that is characterized by no clinical symptoms and symptomatic which has no inflammation but abdominal pain with change in bowel habits are high-fiber diet. Marinella (2010) found that for uncomplicated diverticulitis, with fever and abdominal pain can be treated with oral antibiotics, bowel rest, clear liquid diet and total abstinence from morphine because morphine has the risk of intracolonic pressure increased. This type of uncomplicated diverticulitis is for a young stable patient. For an older patient with uncomplicated diverticularitis, IV antibiotics should be administered but nothing by mouth.

Fifteen percent of the remaining patients develop symptoms of their diverticulosis, while the remaining five percent develop diverticulitis. The symptoms of diverticulosis are often hard to differentiate and determine because they are often nonspecific symptoms, such as simple abdominal pain that is relieved by moving their bowels (Marrs, 2006). Once inflammation occurs, the diverticulosis is progressed to diverticulitis. This inflammation occurs from the large number of bacteria that target the areas of weakened gastrointestinal wall and combine with undigested foods. It is still unknown today why some diverticula became inflamed while others do not. There are some theories surrounding this issue that states the inflammation occurs only when the erosion of the colon wall is so bad that the body’s immune system is unable to protect such a large, disrupted area. In some cases, the inflammation gets so bad and infection co-exists. This combination can result in the enlargement of the infection, allowing it to extend into the abdomen and become peritonitis when it infects the lining of the abdomen (Unknown, 2010).

The most symptoms of ulcerative colitis are abdominal pain and bloody diarrhea mixed with pus, blood and mucus. Individuals may become very sick and weak, they can suffer form anemia, weight loss, loss of appetite, rectal bleeding, loss of body fluids and nutrients, skin lesion, joint pain, and growth failure specially in children according to the extent of the disease. Just how risk factors have a different affects on everyone symptoms are also different. A quarter of the patients only have the disease only have mild symptoms while others suffer from fevers, bloody diarrhea, nausea and severe abdominal cramps. Complications may also occur outside the colon such as arthritis, inflammation of the