Localised minor infections may settle down with conservative measures, but abscesses and obstruction need surgical intervention. Some patients develop internal fistulae with the urinary bladder or the vagina. These fistulae never heal spontaneously. Subacute obstruction is common. It is caused by luminal narrowing due to inflammation, fibrosis or compression by the pus.
Complete obstruction is rare.
Clinical features Diverticulosis is asymptomatic and is often an incidental finding on barium studies done for GI symptoms. Diverticulitis presents a clinical picture aptly described as left sided appendicitis. Presence of a lump in the lower abdomen is one presentation typically seen in patients admitted as emergencies. There is a history of repeated attacks of pain either due to infection or narrowing of the colon with subacute obstruction. In almost every case of colo-vesical fistula, the patients are treated for a long time for recurrent episodes of urinary tract infections.