Occurs in 10 to 25% of people with diverticulosis.
Perforation of diverticulum.
LLQ pain, +/- fever, leukocytosis, and a palpable mass.
Differential diagnosis includes malignancy, ischemic colitis, infectious colitis, and inflammatory bowel disease
50 to 70% will have no further episodes.
Increased risk of complications with recurrent disease.
Because colon carcinoma may have an identical clinical presentation to diverticulitis all patients must be evaluated for malignancy after resolution of the acute episode.
Complicated diverticulitis includes diverticulitis with:
diffuse peritonitis (free perforation)
or fistulas between the colon and adjacent structures.
Colovesical, colovaginal, and coloenteric fistulas
Hinchey staging system
Classification of Diverticulitis
Stage I: Pericolic or mesenteric abscess Stage II: Walled-off pelvic abscess Stage III: Generalized purulent peritonitis Stage IV: Generalized fecal peritonitis