Signs of diverticulitis | Diverticulitis

Signs of diverticulitis

The three classic signs of existing diverticulitis are: The abdominal pain may radiate into the back and be accompanied by a spatially limited defense tension of the abdominal muscles (local peritonitis) in the painful abdominal area. However, the abdominal pain does not always necessarily have to be felt in the right lower abdomen (see: Lower abdominal pain), so that other abdominal regions can also become painful, depending on the section of the colon affected. Other signs that can accompany this classic symptom triad of diverticulitis include nausea and vomiting, constipation or diarrhea, as well as mucus or pus in the stool and difficult urination (dysuria).

  • Relatively sudden pain, which in most cases is felt in the right lower abdomen,
  • An increased body temperature and
  • An increase in white blood cells (leukocytosis) and inflammation values (CRP) in the blood count.

Pain with diverticulitis

Depending on the severity of the diverticulitis, different forms of pain and other symptoms of the disease can occur. In general, there is often dull, uniform pain in the left lower abdomen, which is called “left-sided appendicitis” in medical terminology, as it can resemble the painful character of appendicitis, which usually occurs in the right lower abdomen, on the left side. However, the pain does not necessarily have to occur in the left lower abdomen, but can in principle affect the entire colon, although this is rarely found.

In addition, diverticulitis is often referred to as ” appendicitis of the elderly” because it usually occurs in older people and many similarities can be found with the symptoms of appendicitis. The pain can sometimes radiate into the back. If an intestinal perforation has already occurred in the area of an intestinal wall protrusion (diverticulum), even more severe, very sudden pain can occur, accompanied by signs of inflammation such as fever, nausea and vomiting.

A symptomless diverticulitis is usually only a coincidental finding of a colonoscopy. An inflammation of the diverticula, on the other hand, can be diagnosed by means of The diverticula can be visualized by ultrasound. If they are inflamed, the wall is thickened.

The diverticula can also be detected in computed tomography. With the help of contrast medium, thickened walls can also be seen here. In very severe cases it may also be necessary to perform an MRI of the abdomen.

A breakthrough of the inflamed protrusions was recognized in the X-ray image by so-called “free air”. Free air is shown in black. It is caused by air escaping from the ruptured intestinal loops.

The peristalsis (movement of the intestine), which is still present, forces air out of the intestine. This air always accumulates at the top. Depending on the patient’s position during the X-ray, free air can therefore be assessed at certain points. Free air must be distinguished from air in the intestinal loops.

  • The symptoms/complaints
  • The blood count (laboratory values)
  • Ultrasound or
  • X-ray