Diverticulitis: Clinical Scenarios
1. A 54-year old man presents to A&E with a 4-day history of colicky lower abdominal pain, abdominal distention and claims he has not passed faeces for the past 2 days. On examination the patient is afebrile and has a pulse rate of 84 bpm. Palpation of the abdomen reveals a firm non-tender lesion in the left iliac fossa. Digital rectal examination is unremarkable.
2. A 72-year old women presents to A&E with a 6 hour history of passing dark red blood per rectum independent of the passage of stool. On examination her abdomen is soft and non-tender with no palpable masses.
3. A 65-year old woman presents to A&E with 7-day history of colicky right iliac fossa pain associated with constipation and a persistent fever. Direct questioning reveals previous similar episodes of lesser severity. On examination she has a temperature of 37.8 C, pulse rate of 98 bpm, an old grid-iron scar and a tender indistinct mass in the right iliac fossa.
2. A 72-year old women presents to A&E with a 6 hour history of passing dark red blood per rectum independent of the passage of stool. On examination her abdomen is soft and non-tender with no palpable masses.
3. A 65-year old woman presents to A&E with 7-day history of colicky right iliac fossa pain associated with constipation and a persistent fever. Direct questioning reveals previous similar episodes of lesser severity. On examination she has a temperature of 37.8 C, pulse rate of 98 bpm, an old grid-iron scar and a tender indistinct mass in the right iliac fossa.