A wide range of diseases can manifest in the large intestine, ranging from asymptomatic to particularly painful. Colon diseases with severe symptoms include diverticulitis, which can be potentially dangerous for the health of patients. The condition begins when diverticula, which are small bubble-like protrusions that protrude through the muscle layers of the intestinal wall, form in the lining of the colon. The formation of diverticulitis is medically called diverticulosis and usually causes no symptoms. However, a problem arises when inflammation develops in the diverticula, which is usually acute and with strong symptoms. This condition is called acute diverticulitis and can cause a range of symptoms ranging from mild discomfort to serious complications such as bowel perforation or peritonitis.
Acute diverticulitis causes
The exact etiology of acute diverticulitis remains multifactorial, with a combination of genetic, environmental and lifestyle factors contributing to its development. A low-fiber diet, obesity, sedentary lifestyle, and smoking have been identified as potential risk factors. Genetic predisposition may play a role in the development of diverticula, while changes in colonic motility have been implicated in the pathogenesis of the disease.
Acute diverticulitis: Symptoms & complications
The clinical presentation of acute diverticulitis in general can vary in terms of intensity and severity of symptoms. Common symptoms include abdominal pain in the lower left side of the abdomen, fever, chills, and feeling bloated. Patients may also experience nausea, vomiting and loss of appetite. Acute diverticulitis can be potentially dangerous as it is likely to cause serious complications. These include intra-abdominal abscess or fistula formation, bowel perforation, peritonitis and narrowing of the intestinal lumen, which can lead to more severe symptoms and usually require immediate medical intervention.
Diagnosis of acute diverticulitis
The diagnosis of acute diverticulitis is made through a combination of clinical examination, laboratory and imaging tests. Clinical examination may reveal tenderness on the lower left side of the abdomen, while laboratory blood tests can help assess the severity of the inflammation. Imaging tests, such as a CT scan, are important to confirm the diagnosis, detect any complications, and create an appropriate treatment plan.
Acute diverticulitis: Treatment options
The appropriate treatment plan for acute diverticulitis depends on the severity of the condition and the presence of complications. Mild cases can be treated with conservative measures that include antibiotics to reduce inflammation and pain management with pain relievers. If the symptoms are particularly severe, it is considered appropriate to hospitalize the patient for intravenous administration of antibiotics and serum and careful monitoring.
However, if acute diverticulitis has caused complications or has recurred, surgery is required. The operation recommended in these cases is to remove the problematic part of the intestine, especially if the patient is diagnosed with intestinal perforation or generalized peritonitis. This operation is called a colectomy, and it can now be successfully performed laparoscopically (laparoscopic colectomy). During the operation, the affected part of the intestine is resected and its two ends are carefully reconnected. However, in cases of perforation of the intestine at the point where the inflammation is located it may not be possible to reconnect the ends of the organ. In this case, a colostomy is created, until the inflammation subsides and the patient recovers. When this is done, a second procedure is performed in which the two ends of the colon are finally reconnected.
Acute diverticulitis is a common condition with a complex etiology and varied symptoms. Early and accurate diagnosis, combined with the application of appropriate therapeutic strategies, is crucial for the successful cure of the condition and the avoidance of both possible complications and future recurrences. The General Surgeons in Athens, who make up the Colon Rectal team, treat acute diverticulitis surgically, either with open surgery or more commonly through laparoscopic surgery techniques.
