Discussion Diverticulitis is classically diagnosed clinically with fever, acute abdominal pain possibly with fullness localized to the left lower quadrant, and leukocytosis as demonstrated by our young native male. Definitive studies include computerized tomography, barium enema, and colonoscopy. Abdominal tomography is helpful in the initial evaluation to delineate potential areas of inflammation, abscesses, or associated abdominal pathology. With failure of conservative therapy, barium enema can be utilized to confirm the diagnosis. If symptoms resolve yet rectal bleeding persists, colonoscopy is considered mandatory to rule out carcinoma.
Treatment varies depending upon presentation.
Conservative therapy with broad spectrum antibiotics is often successful in treating mild exacerbations and can be initiated upon initial presentation as done for our patient. Operative intervention is indicated for those patients who present with signs of peritonitis, hemorrhage, or fail medical therapy. The disease may act with greater virulence in the young and is associated with a higher incidence of morbidity and mortality. Those under fifty years of age are also more likely to fail conservative management. 9 Epidemiologists have long considered diets low in fiber as a possible etiologic factor in the development of diverticular disease.