Essay Prompt
Compare and contrast the pathophysiology of diverticular disease (diverticulosis) and acute diverticulitis. (CO1)\nIdentify risk factors for acute diverticulitis and the clinical signs and symptoms associated with the disease. (CO3)\nExplain the significance of physical exam and diagnostic findings in the diagnosis of diverticular disease. (CO4)\nCase Scenario:\nAn 84-\u202fyear-old\u202f-female who has a history of diverticular disease presents to the clinic with left lower quadrant (LLQ) pain of the abdomen that\u202fis accompanied\u202fby with constipation, nausea, vomiting and a\u202flow-grade\u202ffever (100.20\u202fF) for 1 day.\nOn physical exam the patient appears unwell. She has signs of dehydration (pale mucosa, poor skin turgor with mild hypotension \\[90/60 mm Hg\\] and tachycardia \\[101 bpm\\]). The remainder of her exam is normal except for her abdomen where the NP notes a distended, round contour. Bowel sounds a faint and very hypoactive. She is tender to light palpation of the LLQ but without rebound tenderness. There is hyper-resonance of her abdomen to percussion.\nThe following diagnostics reveal:\nStool for occult blood is positive.\nFlat plate abdominal x-ray demonstrates a bowel-gas pattern consistent with an ileus.\nAbdominal CT scan with contrast shows no evidence of a mass or abscess. Small bowel in distended.\nBased on the clinical presentation, physical exam and diagnostic findings, the patient is diagnosed with acute diverticulitis and she is admitted to the hospital. She is prescribed intravenous antibiotics and fluids (IVF). Her symptoms improved and she could tolerate a regular diet before she was discharged to home.\nDiscussion Questions:\nCompare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.\nIdentify the clinical findings from the case that supports a diagnosis of acute diverticulitis.\nList 3 risk factors for acute diverticulitis.\nDiscuss why antibiotics and IV fluids are indicated in this case.