1. Compare and contrast the pathophysiology between diverticular disease
(diverticulosis) and diverticulitis.
Reviewing several articles regarding diverticular disease (DD), the common
thread amongst medical professionals regarding its pathophysiology is not truly
understood. Scientists all agree that there are many contributors to the cause of
DD such as colonic wall structure deviations, motility, the amount of food that is
ingested, and obesity without physical activities (Piscopo and Ellul, 2020).
McCance textbook also states that pre-disposessing factors for this condition
also can include genetics, obesity, diet, medications, and age. Old school
thought was that nuts, seeds, corn, and popcorn were also contributors to acute
diverticulitis, however, more studies have recently come out that deny that
assumption (El-Sayed et al., 2018).
Diverticulitis results from micro and macro perforations that occur in the
diverticular wall. These can be caused by increased pressure from food particles
remaining in the diverticulum that, over time erodes the lining of the diverticular
wall. Eventually, not always, these erosions can lead to formations of abscesses
or obstructions (Linzay and Pandit, 2023).
2. Identify the clinical findings from the case that support a diagnosis of acute
diverticulitis.
Pt is elderly with a past medical history of diverticular disease. She presented with left
lower quadrant pain. Her low-grade fever is indicative of infection, as well as the
nausea and vomiting with constipation.
Her abdomen is distended, round, and tender to touch. Bowel sounds are hypoactive
with a hyper resonance upon percussion.
3. List 3 risk factors for acute diverticulitis.
1. Excess use of aspirin, COX inhibitors, and NSAIDS
2. Aging/elderly (>60), obesity
3. physical activity or lack thereof, dietary intake such as nuts, corn, and popcorn
consumption, smoking
4. Discuss why antibiotics and IV fluids are indicated in this case.
