Diverticulitis Of Colon Differential Diagnosis Table

Diverticulitis Of Colon Differential Diagnosis Table:

Diverticula are evaginations of the intestine. There are true diverticula and false diverticula.
True diverticula: They have all the layers of the intestine in the diverticulum’s wall. Examples: appendix, Meckel’s diverticulum.
False diverticula: They do not have all the layers of the intestine in the diverticulum’s wall; the missing layer is the muscular one since it is caused by a weakness of the muscular layer of the colon, usually due to chronic constipation. Diverticula can be multiple or solitary.

With this condition, it is necessary to address the differences of these 3 terms:
Diverticulosis: Is defined as the presence of diverticula. It is asymptomatic, frequent in patients over 50 years old. It is associated with constipation and is frequently located in the sigmoid colon. It is usually diagnosed during a follow-up colonoscopy.
Diverticulitis: Occurs when diverticulosis is exacerbated when the diverticulum becomes inflamed. It occurs in patients over 50 years old too, also associated with chronic constipation. It occurs when the base of the diverticulum is obstructed by a fecalith or foreign body. The clinical picture presents with: pain in the left iliac fossa + peritoneal irritation + leukocytosis. It is diagnosed by CT Scan. They present with: intermittent colic pain over the left lower quadrant accompanied by: abdominal distension, flatulence, food intolerance, pain related to defecation or flatulence.
Diverticular hemorrhage: Epidemiologically affects people over 50 years too, located in the ascending colon. It is the first cause of massive lower gastrointestinal bleeding. During a medical examination, there is: intense, massive bleeding.

How to Distinguish Diverticulitis of Colon from Other Diseases

Distinguish UTI (Urinary Tract Infection) from Diverticulitis of Colon – Diagnosis

Urinary tract infections occur when bacteria enter the urethra; these bacteria come from the skin or the rectum into the urinary tract.

• The most common secondary complication of diverticular disease and colorectal cancer is colovesical fistula, which leads to a classic triad of: suprapubic pain, dysuria, and tenesmus. There can also exist gastrointestinal symptoms such as abdominal pain, while diverticulitis clinical picture is a clinical picture presents with: pain in the left iliac fossa + peritoneal irritation + leukocytosis.

Distinguish IBS (Irritable Bowel Syndrome) from Diverticulitis of Colon – Diagnosis

Irritable bowel syndrome is one of the most common functional gastrointestinal disorders. It is the result of a poor interaction between hereditary and genetic factors, motility alterations, visceral hypersensitivity, enteric infections, altered microflora and bacterial overpopulation, psychosocial factors, and diet.

• Diverticulitis of colon is an infectious inflammatory process that is caused by a perforation of a diverticulum of the intestine, while irritable bowel syndrome is an idiopathic gastrointestinal disorder that is characterized by chronic abdominal pain and alteration of the intestinal habit.

Distinguish Ovarian Cyst/Torsion from Diverticulitis of Colon – Diagnosis

It is a gynecological emergency. Ovarian torsion occurs when one of the ovaries twists around its stem.

• Ovarian torsion’s most common symptoms are severe abdominal pain, cramps, nausea, and vomiting. Patients may have symptoms of appendicitis or urinary tract infection, while diverticulitis clinical picture presents with: pain in the left iliac fossa + peritoneal irritation + leukocytosis.

Distinguish Appendicitis from Diverticulitis of Colon – Diagnosis

It is the most common cause of abdominal surgery. It’s the inflammation of the appendix.

• Among Appendicitis causes are considered: Genetic, anatomical, infectious, parasitic, immunological factors, and foreign bodies that can cause obstruction of the appendicular lumen, while the causes of diverticulitis are: aging, obesity, high-fat, and low-fiber diet.
• Appendicitis clinical picture of appendicitis consists of: presence of abdominal pain that starts in the epigastrium or umbilical region, or right iliac fossa. Symptoms that may occur are: nausea, vomiting, anorexia. During physical examination, there is increased muscle tone, decreased peristaltic sounds, pain on deep palpation, and painful decompression, while diverticulitis clinical picture presents with: pain in the left iliac fossa + peritoneal irritation + leukocytosis.
• The following signs are positive for appendicitis during physical exam: McBurney, Lanz, psoas, Rovsing, Capurro, and obturator, while diverticulitis only presents pain in the left iliac fossa unless it occurs on the right side, which will present as an appendicitis.

Distinguish Colorectal Cancer from Diverticulitis of Colon – Diagnosis

Colorectal cancer is a type of cancer that affects the colon or the rectum.

• Colorectal cancer’s most common symptoms are hematochezia or melena, abdominal pain, iron deficiency, anemia, changes in bowel pattern. Other symptoms are nausea, vomiting, and abdominal distension, while diverticulitis clinical picture presents with: pain in the left iliac fossa + peritoneal irritation + leukocytosis.
• Among the findings during the physical examination in colorectal cancer is the presence of a palpable mass in the abdomen, unlike diverticulitis that does not present this finding.

Common Red Flags with Diverticulitis of Colon

Diverticular disease is an important cause of morbidity and mortality in the Western world.
The prevalence has been increasing over recent years mainly in the young population due to fiber crossbow which leads to an increase in colonic population (risk factor)