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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