Acute Colonic Diverticulitis

Acute colonic diverticulitis is a gastrointestinal condition frequently encountered by primary care and emergency department practitioners, hospitalists, surgeons, and gastroenterologists. Clinical presentation ranges from mild abdominal pain to peritonitis with sepsis. It can often be diagnosed on the basis of clinical features alone, but imaging is necessary in more severe presentations to rule out such complications as abscess and perforation. Treatment depends on the severity of the presentation, the presence of complications, and underlying comorbid conditions. Medical and surgical treatment algorithms are evolving. This article provides an evidence-based, clinically relevant overview of the epidemiology, diagnosis, and treatment of acute diverticulitis.

Use this article to:

  • Review the presentation of diverticulitis.
  • Review the appropriate use of imaging, laboratory tests, and endoscopy in diagnosing diverticulitis.
  • Identify risk factors for diverticulitis.
  • When is it appropriate to consider hospitalization for a patient with acute diverticulitis?
  • Review the ACP clinical guideline on the diagnosis and management of acute diverticulitis.
  • If possible, consult a gastroenterologist to discuss differences in the ACP recommendations and those from gastroenterology organizations.
  • Complete the quiz that accompanies the article and then review the correct answers.

In the Clinic is a feature of Annals of Internal Medicine which includes practical reviews about the management of common clinical conditions.

Back to the April 2024 issue of ACP IMpact