History and exam

Key diagnostic factors

common

presence of risk factors

Risk factors include low dietary fibre intake and age older than 50 years.

left lower quadrant abdominal pain

May be mild in uncomplicated diverticular disease.

Present in approximately 70% of patients with acute diverticulitis.[32]

leukocytosis

A good indication of acute diverticulitis when present in older patients with a history of diverticulosis.

fever

A low grade temperature frequently accompanies episodes of diverticulitis.

uncommon

rectal bleeding

Usually abrupt, painless, profuse arterial lower gastrointestinal bleeding; complication of acute diverticular disease.

Other diagnostic factors

common

guarding in left lower quadrant

In acute diverticulitis.

tenderness in left lower quadrant

In acute diverticulitis.

bloating

Abdominal bloating is a frequent complaint of patients with diverticular disease.

constipation

Patients with diverticular disease often experience periods of constipation, which may alternate with episodes of diarrhoea.

pelvic tenderness on digital rectal examination

This may be detected, particularly if there is acute diverticulitis.

uncommon

diffuse abdominal tenderness

In cases of free perforation and generalised peritonitis.

diarrhoea

Patients with diverticular disease often experience episodes of diarrhoea, which may alternate with periods of constipation.

palpable abdominal mass

May indicate abscess.

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