Acute Diverticulitis Diagnosis and Management

Clinical Presentation

Left lower quadrant pain with mild tenderness is the most common presenting symptom in adults with diverticulitis, as reported by the American Academy of Family Physicians 1, 2
Segmental bowel wall thickening on CT scan of the descending and sigmoid colon represents one of the most common CT findings in acute diverticulitis, along with pericolonic fat stranding, according to the American Academy of Family Physicians 1, 3
Elevated white blood cell count supports an inflammatory process consistent with diverticulitis, as noted by the American Academy of Family Physicians 2

CT findings are diagnostic for diverticulitis with sensitivity and specificity as high as 100%, as reported by the American Academy of Family Physicians 1, 2
Segmental thickening of the descending and sigmoid colon is one of the three most common CT findings in acute diverticulitis, according to the American Academy of Family Physicians 1, 3
CT is the preferred imaging modality for suspected diverticulitis and has a critical role in determining disease extent and severity, as noted by the American Academy of Family Physicians 1, 2

Colonoscopy should be performed 6-8 weeks after resolution of acute symptoms to exclude underlying malignancy, as recommended by the American College of Gastroenterology 4
Red flags that would suggest complicated diverticulitis requiring more aggressive intervention include fever, inability to pass gas/stool, severe tenderness with guarding, vomiting, or signs of shock, as reported by the American College of Surgeons 6
Uncomplicated diverticulitis can typically be managed medically, as noted by the American College of Physicians 5