Diverticulitis
• Discuss a brief HPI, Pertinent subjective and objective complaint data.
75y/o female with known history of DM type 2, Hypothyroid, Hyperlipidemia, Diverticulitis. Presents to the ER with complaints of abdominal pain. Reports abdominal pain began on 1/18/23 evening with sudden onset with intermittent pain. Today states pain has intensified and describes it as “sharp” to LLQ 8/10 pain scale. Denies any fever, chills, headache, light-headed, dizziness. States notices small amount of bloody mucus stool. Does have a history of Diverticulitis last flare up per patient was a few years ago.
HC: IV fluids initiated. Patient has a PCN allergy. Levaquin and Flagyl x1 IV dose given in the ER. Stool sample collected. WBC elevated; blood cultures collected. Placed on NPO. The hospitalist team agreed to admit for further evaluation and management.
• Pick one disorder to explore related to the case and summarize the pathophysiology behind the disorder.
Diverticulitis
• Present the current management recommendations for the disorder. This must be based on current evidence or guidelines.
• Discuss the actual plan that was implemented in the clinical setting for this patient.
o Were guidelines followed? If not please explain further.
o When discussing the plan, address labs that were ordered, medications prescribed/ordered, referrals or consultations.
o Discuss WHY each of the components of the plan were implemented.
Sample Solution
Diverticulosis occurs when small, bulging pouches (diverticular) develop in your digestive tract. When one or more of these pouches become inflamed or infected, the condition is called diverticulitis. Diverticulitis is usually diagnosed during an acute attack. Treatment depends on the severity of your signs and symptoms. The doctor is likely to recommend antibiotics to treat infection, although new guidelines state that in very mild cases, they may not be needed; a liquid diet for a few days while your bowel heals. Radiologically guided percutaneous drainage is usually the most appropriate treatment for patients with a large diverticular abscess as it avoids the need for emergency surgery and possibility of a colostomy.
