Diverticulitis

HISTORY:

‍LLQLeft flankAbdominal pain for ‍ ‍hoursdays

Onset: ‍gradualsudden, following ‍

Location: ‍left lower quadrantdiffuse

Radiation: ‍none

Severity: ‍mildmoderatesevere, ‍012345678910 / 10

Type: ‍crampingsharp

Pattern: ‍constantintermittent

Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective

‍fever, up to ‍°, over ‍ ‍hoursdays

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍

‍constipation

‍diarrhea, ‍ episodes ‍per day, ‍

‍hematochezia

‍melena

‍bloating

‍rectal bleeding, ‍oncetwice ‍, ‍bright reddark red, ‍withwithout clots

‍dysuria

‍frequency

‍hematuria



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Pelvic: vulva ‍normal, vagina ‍normal, cervix ‍normal, uterus ‍normal, adnexa ‍normal, ‍no cervical motion tenderness

Genital: ‍normal, testicles ‍normal, penis ‍normal



ASSESSMENT:

‍Diverticulitis ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Blood work: ‍CBC, ‍CRP, ‍electrolytes, ‍creatinine, ‍LFTs, ‍ß-hCG

- CT scan of abdomen could be optional if diagnosis is clear and symptoms are mild

- Urinalysis, urine culture

- Abdominal ultrasound

- Colonoscopy

- ‍Dietary modificationsNPO

- ‍Antibiotics

- ‍Analgesics

- Clear liquid diet until symptoms improve

- Gradual reintroduction of fiber into diet

- Increase fluid intake

- Referral to gastroenterologist

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as fever, vomiting, or increased pain

- Go to ER if severe abdominal pain, severe vomiting, or fever occurs