gastrointestinal disorders
Colonic Diverticulitis
Symptoms and Signs of Colonic Diverticulitis
Patients have left lower quadrant abdominal pain and tenderness and often have a palpable sigmoid; pain is occasionally suprapubic. However, Asian patients with diverticulitis often present with right-sided pain due to right colon involvement. The pain can be accompanied by nausea, vomiting, fever, and sometimes even urinary symptoms as a result of bladder irritation. Peritoneal signs (eg, rebound or guarding) may be present, particularly with abscess or free perforation. Fistula may manifest as pneumaturia, fecaluria (feces in the urine), feculent vaginal discharge, or a cutaneous or myofascial infection of the abdominal wall, perineum, or upper leg. Patients with bowel obstruction have nausea, vomiting, and abdominal distention. Bleeding is uncommon. Recurrent episodes of acute diverticulitis manifest similar to initial episodes; they are not necessarily more severe. 